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1972024214
JIM WAYNE FIELDS
TIGARD, OR
NPI
1972024214
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR T-17-058)
Enumeration Date
2017-06-27
Last Update Date
2017-06-27
Business Address
JIM WAYNE FIELDS
10763 SW GREENBURG RD
TIGARD, OR 97223-5492
Phone number: 503-684-8159
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Mailing Address
JIM WAYNE FIELDS
10763 SW GREENBURG RD STE 100
TIGARD, OR 97223-5492
Phone number: 503-684-8159
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