Individual
CHARLES DWIGHT HANNAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3034 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97212-3053
(503) 889-2500
(503) 735-0912
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/24/2012
Last updated
05/24/2012
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