Individual
BENJAMIN JOHN ZIMMERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.A.
Contact information
Practice address
13317 SE POWELL BLVD, PORTLAND, OR 97236-3335
(503) 760-9606
(503) 760-9609
Mailing address
847 NE 19TH AVE, SUITE 100, PORTLAND, OR 97232-2684
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
07/25/2011
Last updated
07/25/2011
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