Straight From The Heart | |
5404 N Montana Ave Portland OR 97217-4557 | |
(503) 232-0969 | |
(503) 234-2326 |
Full Name | Straight From The Heart |
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Speciality | Social Worker - Clinical |
Location | 5404 N Montana Ave, Portland, Oregon |
Authorized Official Name and Position | Paul Jerome Stretch (PRESIDENT OF STRAIGHT FROM THE HEAR) |
Authorized Official Contact | 5032320969 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Straight From The Heart 5404 N Montana Ave Portland OR 97217-4557 Ph: (503) 232-0969 | Straight From The Heart 5404 N Montana Ave Portland OR 97217-4557 Ph: (503) 232-0969 |
NPI Number | 1972639458 |
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Provider Enumeration Date | 02/26/2007 |
Last Update Date | 10/28/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972639458 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | ALICE RICHARD LIC# 1 (Oregon) | Primary |
1041C0700X | Social Worker - Clinical | PAUL STRETCH #1994 (Oregon) | Secondary |
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