WYATT FERNELIUS

PORTLAND, OR
NPI1982127874
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
Enumeration Date2017-07-21
Last Update Date2017-07-21
Business Address
WYATT FERNELIUS QMHA
2640 NW ALEXANDRA AVE
PORTLAND, OR 97210-1289
Phone number: 503-731-3978
Mailing Address
WYATT FERNELIUS QMHA
PO BOX 10027
PORTLAND, OR 97296-0027
Phone number: