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1932639945
KENNYON PETERKIN
PORTLAND, OR
NPI
1932639945
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-06-13
Last Update Date
2018-04-11
Business Address
KENNYON PETERKIN CRM
2600 SE BELMONT ST
PORTLAND, OR 97214-2916
Phone number: 503-239-5738
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Mailing Address
KENNYON PETERKIN CRM
2600 SE BELMONT ST
PORTLAND, OR 97214-2916
Phone number: 503-239-5738
Copy
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