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1811034069
PHYLLIS MICHELLE BRAXTON
PORTLAND, OR
NPI
1811034069
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2007-01-30
Last Update Date
2007-07-08
Business Address
-- PHYLLIS MICHELLE BRAXTON QMHA
11261 NE KNOTT ST
PORTLAND, OR 97220-1704
Phone number: 503-253-8883
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Mailing Address
-- PHYLLIS MICHELLE BRAXTON QMHA
4025 NE 109TH AVE
PORTLAND, OR 97220-2612
Phone number: 503-891-0676
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