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1760228787
ABBIE SISOUPHANH
PORTLAND, OR
NPI
1760228787
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: OR R9891)
Enumeration Date
2024-07-09
Last Update Date
2024-09-18
Business Address
ABBIE SISOUPHANH MS, CRC
4531 SE BELMONT ST
PORTLAND, OR 97215-1699
Phone number: 000-000-0000
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Mailing Address
ABBIE SISOUPHANH MS, CRC
4531 SE BELMONT ST STE 315
PORTLAND, OR 97215-1675
Phone number: 503-317-6802
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