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Individual

BRIAN THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
14600 NW CORNELL RD, PORTLAND, OR 97229
(503) 645-3581
Mailing address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
372600000X
Adult Companion

Other

Enumeration date
03/21/2007
Last updated
09/13/2019
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