Individual
THEA MARIE BASMILLO LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
10700 SW BEAVERTON HILLSDALE HWY STE 11, BEAVERTON, OR 97005-3035
(503) 641-1475
Mailing address
5415 SW WESTGATE DR, PORTLAND, OR 97221-2409
(503) 645-3581
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/28/2021
Last updated
05/28/2021
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