Individual
VALENCIA WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSS
Contact information
Practice address
17882 SE MCLOUGHLIN BLVD, MILWAUKIE, OR 97267-6103
(503) 353-9415
Mailing address
17882 SE MCLOUGHLIN BLVD, PORTLAND, OR 97267-6103
(503) 353-9415
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
111402
OR
Other
Enumeration date
06/11/2024
Last updated
06/11/2024
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