Individual
SALLY BLOOMSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14025 SW FARMINGTON RD, BEAVERTON, OR 97005-2512
(971) 330-9228
Mailing address
11495 SW CARDINAL TER, BEAVERTON, OR 97008-5958
(971) 260-7146
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
06/20/2016
Last updated
06/20/2016
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