Individual
THEODORE TRUESDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
310 NW FLANDERS ST, PORTLAND, OR 97209-3941
(503) 827-3949
Mailing address
310 NW FLANDERS ST, PORTLAND, OR 97209-3941
(503) 827-3949
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
06/04/2012
Last updated
11/04/2013
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