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1982284865
TEJ MIGUEL PEREIRA AMBROSE
PORTLAND, OR
NPI
1982284865
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Professional Name
MARA AMBROSE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2021-04-13
Last Update Date
2021-04-13
Business Address
TEJ MIGUEL PEREIRA AMBROSE
9125 SW 55TH AVE
PORTLAND, OR 97219-5018
Phone number: 503-477-4622
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Mailing Address
TEJ MIGUEL PEREIRA AMBROSE
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number:
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