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1962039602
MIA PHAE
PENDLETON, OR
NPI
1962039602
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2020-03-24
Last Update Date
2020-03-24
Business Address
MIA PHAE
2575 WESTGATE BLDG 3
PENDLETON, OR 97801-9613
Phone number: 541-276-6330
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Mailing Address
MIA PHAE
3587 HEATHROW WAY
MEDFORD, OR 97504-4004
Phone number: 541-858-8170
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