RYAN AUSTIN FULLMER

PORTLAND, OR
NPI1750954442
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2021-07-20
Last Update Date2021-07-20
Business Address
RYAN AUSTIN FULLMER
12505 SE RAYMOND ST
PORTLAND, OR 97236-3931
Phone number: 503-760-8300
Mailing Address
RYAN AUSTIN FULLMER
3587 HEATHROW WAY
MEDFORD, OR 97504-4004
Phone number: 541-858-8170
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