Individual
MR. SAMUEL WAINE OSWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
707 NE COUCH ST, PORTLAND, OR 97232-2922
(503) 542-4603
(503) 233-6093
Mailing address
6455 SW NYBERG LN APT H101, TUALATIN, OR 97062-7450
(503) 805-5716
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0177
OR
Other
Enumeration date
09/17/2013
Last updated
09/17/2013
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