ANTONIO LAVELLE DARSHIE MARTIN

PORTLAND, OR
NPI1760020994
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2019-12-18
Last Update Date2019-12-18
Business Address
Mr. ANTONIO LAVELLE DARSHIE MARTIN
527 SE MORRISON ST
PORTLAND, OR 97214-2300
Phone number: 503-501-5294
Mailing Address
Mr. ANTONIO LAVELLE DARSHIE MARTIN
8915 SW CENTER ST
TIGARD, OR 97223-6307
Phone number: 503-726-3690
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