Individual
TIFFANY CHRISTINE BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHA
Contact information
Practice address
5230 SE ROETHE RD, MILWAUKIE, OR 97267-5051
(503) 238-0769
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
04/30/2012
Last updated
04/30/2012
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