Individual
MS. ERICA ROSE SANDSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10313 SW 69TH AVE, TIGARD, OR 97223-9103
(503) 726-3690
Mailing address
10313 SW 69TH AVE, TIGARD, OR 97223-9103
(503) 726-3690
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OR
Other
Enumeration date
03/06/2012
Last updated
03/06/2012
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