ANTHONY W VELASQUEZ

PORTLAND, OR
NPI1912482092
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  18-P-17)
Enumeration Date2018-09-25
Last Update Date2018-09-25
Business Address
ANTHONY W VELASQUEZ
1316 SE 12TH AVE
PORTLAND, OR 97214-3604
Phone number: 503-897-1916
Mailing Address
ANTHONY W VELASQUEZ
1316 SE 12TH AVE
PORTLAND, OR 97214-3604
Phone number: 503-897-1916