Individual
QUANTRELL JAMAL BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8915 SW CENTER ST, TIGARD, OR 97223-6307
(503) 726-3690
(503) 726-3691
Mailing address
5316 SE REDBERRY PL, HILLSBORO, OR 97123-8881
(503) 268-9651
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/10/2018
Last updated
07/10/2018
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