WAYNE MARTIN MALLORY

PORTLAND, OR
NPI1881906238
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  09-09-31)
Enumeration Date2010-07-13
Last Update Date2010-07-13
Business Address
-- WAYNE MARTIN MALLORY CADCI
16000 SE POWELL BLVD UNIT 65
PORTLAND, OR 97236-1783
Phone number: 503-239-5738
Mailing Address
-- WAYNE MARTIN MALLORY CADCI
16000 SE POWELL BLVD UNIT 65
PORTLAND, OR 97236-1783
Phone number: 503-239-5738
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