ALEX BLAINE RISSEEUW

LAKE OSWEGO, OR
NPI1962133827
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2022-06-22
Last Update Date2022-06-22
Business Address
ALEX BLAINE RISSEEUW
2507 CHRISTIE DRIVE
LAKE OSWEGO, OR 97034
Phone number: 503-635-3416
Mailing Address
ALEX BLAINE RISSEEUW
PO BOX 230278
PORTLAND, OR 97281-0278
Phone number:
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