Jaelithe Azure Formway-Nelson
Jaelithe Azure Formway-Nelson is a Mental Health Counselor in Tigard, Oregon. Registered with an NPI since 2017.
- In the registry since
- 2017
Practice location Address checks out
8915 SW Center StTigard, OR 97223
Phone: (503) 726-3690
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Mental Health Counselor (primary) | Taxonomy 101YM0800X |
|---|
Record details
| NPI number | 1336679448 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | June 13, 2017 |
| Last updated in NPPES | July 21, 2022 |
| Mailing address | 8915 Sw Center St, Tigard, OR 97223-6307 |
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