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1710174404
CARLY JOANNA THOMPSON
PORTLAND, OR
NPI
1710174404
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
322D00000X Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date
2007-09-26
Last Update Date
2007-09-26
Business Address
-- CARLY JOANNA THOMPSON
722 NE 162ND AVE
PORTLAND, OR 97230-5760
Phone number: 503-255-4205
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Mailing Address
-- CARLY JOANNA THOMPSON
3921 SE SALMON ST
PORTLAND, OR 97214-4432
Phone number:
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