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1912482092
ANTHONY W VELASQUEZ
PORTLAND, OR
NPI
1912482092
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 18-P-17)
Enumeration Date
2018-09-25
Last Update Date
2018-09-25
Business Address
ANTHONY W VELASQUEZ
1316 SE 12TH AVE
PORTLAND, OR 97214-3604
Phone number: 503-897-1916
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Mailing Address
ANTHONY W VELASQUEZ
1316 SE 12TH AVE
PORTLAND, OR 97214-3604
Phone number: 503-897-1916
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