Individual
BENJAMIN PAUL GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
QMHA
Contact information
Practice address
13541 SE MARKET ST, PORTLAND, OR 97233-1752
(503) 258-9734
(503) 258-8892
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 552-6203
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
05/07/2012
Last updated
05/07/2012
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