Individual
PHILIP HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(503) 234-9591
Mailing address
4808 SW OLESON RD, APT F, PORTLAND, OR 97225-1435
(650) 219-4049
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
12/10/2010
Last updated
12/10/2010
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