Individual
GLORIA WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5725 NE PRESCOTT ST, PORTLAND, OR 97218-2229
(503) 548-8085
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
03/23/2009
Last updated
03/23/2009
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