Individual
SITA KABA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1704 NE 26TH AVE, PORTLAND, OR 97212-5005
(971) 673-2555
Mailing address
1704 NE 26TH AVE, PORTLAND, OR 97212-5005
(971) 673-2555
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
NY
Other
Enumeration date
05/03/2024
Last updated
05/03/2024
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