Individual
SHANNON KUUIPOLANI MELE UGAITAFA OMURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
707 NE COUCH ST, PORTLAND, OR 97232-2922
(503) 233-6090
Mailing address
9935 SW 90TH AVE, TIGARD, OR 97223-6647
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0177
OR
Other
Enumeration date
08/28/2013
Last updated
08/28/2013
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