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1750747242
TAMARA LYN MAMETIEFF
PORTLAND, OR
NPI
1750747242
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2016-01-13
Last Update Date
2016-01-13
Business Address
-- TAMARA LYN MAMETIEFF
3415 SE POWELL BLVD.
PORTLAND, OR 97202
Phone number: 503-234-9591
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Mailing Address
-- TAMARA LYN MAMETIEFF
4455 NE HIGHWAY 20
CORVALLIS, OR 97330-9695
Phone number: 541-758-5909
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