Individual
DAISY JOY MONTAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9707 N CLARENDON AVE, PORTLAND, OR 97203-1917
(503) 878-9746
Mailing address
7110 SW FIR LOOP STE 160, TIGARD, OR 97223-8031
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000108868
OR
Other
Enumeration date
02/20/2024
Last updated
02/20/2024
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