PORTLAND DETOX
Residential Treatment Facilities at Waverly Pl, Portland, OR

License number
Oregon AC01151
Category
Residential Treatment Facilities
Type
Substance Abuse Rehabilitation Facility
Owner
Name: BRAD WHISNANT LAC
Title: OWNER
Phone: (503) 750-6238
Address
Address
11160 SW Waverly Pl, Portland, OR 97225
National Provider ID: 1649412511
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

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