Individual
TAWNIE RUTH NAN VINYARD KLECKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8435 NE GLISAN ST, PORTLAND, OR 97220-5814
(503) 235-0131
Mailing address
8435 NE GLISAN ST, PORTLAND, OR 97220-5814
(503) 235-0131
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/11/2024
Last updated
11/07/2025
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