ANTHONY DOUGLAS DEJESUS

PORTLAND, OR
NPI1871140350
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA  CO60778717)
Enumeration Date2019-08-20
Last Update Date2021-02-16
Business Address
Mr. ANTHONY DOUGLAS DEJESUS SUDPt, CADC-R
12662 SE STARK ST
PORTLAND, OR 97233-1058
Phone number: 503-546-7677
Mailing Address
Mr. ANTHONY DOUGLAS DEJESUS SUDPt, CADC-R
16203 NE 32ND ST
VANCOUVER, WA 98682-3674
Phone number: 347-988-2161
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