Individual
ASHLEY BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
805 SE 151ST AVE, PORTLAND, OR 97233-2916
(555) 555-5555
Mailing address
805 SE 151ST AVE, PORTLAND, OR 97233-2916
(555) 555-5555
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/19/2023
Last updated
05/19/2023
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