FIDELIS T EMMANUEL

PORTLAND, OR
NPI1720561970
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Additional Taxonomies372600000X Adult Companion
Enumeration Date2018-09-13
Last Update Date2020-01-24
Business Address
FIDELIS T EMMANUEL
847 NE 19TH AVE STE 100
PORTLAND, OR 97232-2684
Phone number: 503-238-0769
Mailing Address
FIDELIS T EMMANUEL
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number:
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