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1932476173
IVAN MATTHEW KRISTENSEN
TIGARD, OR
NPI
1932476173
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2011-11-16
Last Update Date
2011-11-16
Business Address
-- IVAN MATTHEW KRISTENSEN
10313 SW 69TH AVE
TIGARD, OR 97223-9103
Phone number: 503-726-3690
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Mailing Address
-- IVAN MATTHEW KRISTENSEN
10313 SW 69TH AVE
TIGARD, OR 97223-9103
Phone number: 503-726-3690
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