Individual
AMANDA MARIE STANDIFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
5023 NE KILLINGSWORTH ST, PORTLAND, OR 97218-1915
(503) 284-4249
(503) 284-6585
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
11/29/2011
Last updated
11/29/2011
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