Individual
BRET EUGENE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
037 SW HAMILTON ST, STE 3, PORTLAND, OR 97239-4096
(503) 220-8262
(503) 220-3499
Mailing address
037 SW HAMILTON ST, STE 3, PORTLAND, OR 97239-4096
(503) 754-2634
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
1839
OR
Other
Enumeration date
12/28/2007
Last updated
07/29/2019
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