Individual
TABITHA BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17727 E BURNSIDE ST, PORTLAND, OR 97233-4803
(503) 215-9800
(503) 215-9810
Mailing address
4531 SE BELMONT ST, SUITE 100, PORTLAND, OR 97215-1675
(503) 215-6556
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/17/2015
Last updated
07/17/2015
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