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Individual

MR. ANTHONY BUELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.A., M.A.T., QMHA

Contact information

Practice address
1312 SW WASHINGTON ST, PORTLAND, OR 97205-2327
(503) 535-1151
Mailing address
1312 SW WASHINGTON ST, PO BOX 3007, PORTLAND, OR 97205-2327
(503) 535-1151

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
106S00000X
Behavior Technician

Other

Enumeration date
12/20/2016
Last updated
12/20/2016
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