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Individual

MRS. ANNALEISE MAE MCCULLOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3700 N WILLIAMS AVE, PORTLAND, OR 97227-1441
(503) 281-4852
Mailing address
2115 SW BORLAND RD, WEST LINN, OR 97068-9107

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
05/08/2023
Last updated
07/18/2025
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