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1760891238
DONALD FULTZ
PORTLAND, OR
NPI
1760891238
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2014-08-08
Last Update Date
2014-08-08
Business Address
-- DONALD FULTZ
1312 SW WASHINGTON ST
PORTLAND, OR 97205-2327
Phone number: 503-535-1188
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Mailing Address
-- DONALD FULTZ
1312 SW WASHINGTON ST. P.O. BOX 3007
PORTLAND, OR 97205
Phone number: 503-535-1188
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