Individual
MR. GAYLORD BRUCE MAKOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
147 NW 3RD AVE, CANBY, OR 97013-8749
(503) 266-1951
Mailing address
2694 SE TERRITORIAL RD, CANBY, OR 97013-8749
(503) 266-6108
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T0136
OR
Other
Enumeration date
05/12/2010
Last updated
05/12/2010
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