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1841699238
CARISSA SULLIVAN
PORTLAND, OR
NPI
1841699238
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2014-08-21
Last Update Date
2014-08-21
Business Address
-- CARISSA SULLIVAN
1312 SW WASHINGTON ST
PORTLAND, OR 97205-2327
Phone number: 503-693-3104
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Mailing Address
-- CARISSA SULLIVAN
PO BOX 3007
PORTLAND, OR 97208-3007
Phone number:
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