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1700350402
SEAN NELSON
PORTLAND, OR
NPI
1700350402
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR T-18-469)
Enumeration Date
2019-01-15
Last Update Date
2019-01-15
Business Address
SEAN NELSON
1122 NE 122ND AVE STE 102
PORTLAND, OR 97230-2081
Phone number: 310-750-8960
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Mailing Address
SEAN NELSON
11006 SE HENDERSON DR
PORTLAND, OR 97266-5063
Phone number:
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