Individual
CORIE MATHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRM
Contact information
Practice address
10564 SE WASHINGTON ST, PORTLAND, OR 97216-2809
(503) 228-9229
Mailing address
10564 SE WASHINGTON ST, PORTLAND, OR 97216-2809
(503) 228-9229
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
17-CRM-111
OR
Other
Enumeration date
07/31/2017
Last updated
07/31/2017
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