Individual
ANDRE OTIS WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1904 SE DIVISION ST, PORTLAND, OR 97202-1146
(503) 517-8663
Mailing address
1904 SE DIVISION ST, PORTLAND, OR 97202-1146
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/30/2013
Last updated
05/30/2013
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