Individual
BENJAMIN BASIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5415 SW WESTGATE DR, PORTLAND, OR 97221-2409
(503) 645-3581
Mailing address
5415 SW WESTGATE DR, PORTLAND, OR 97221-2409
(503) 645-3581
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
06/23/2023
Last updated
06/23/2023
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