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Individual

DONALD FULTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1312 SW WASHINGTON ST, PORTLAND, OR 97205-2327
(503) 535-1188
Mailing address
1312 SW WASHINGTON ST., P.O. BOX 3007, PORTLAND, OR 97205
(503) 535-1188

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
08/08/2014
Last updated
08/08/2014
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