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Individual

MRS. TAMMY MARIE BRISTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
QMHA

Contact information

Practice address
1297 RING LN NE, KEIZER, OR 97303-4834
(503) 361-2702
Mailing address
1297 RING LN NE, KEIZER, OR 97303-4834
(503) 361-2702

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
06/14/2007
Last updated
07/08/2007
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