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1013565456
JASON BOURGEOIS
PORTLAND, OR
NPI
1013565456
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2019-08-29
Last Update Date
2019-08-29
Business Address
JASON BOURGEOIS
14600 NW CORNELL RD
PORTLAND, OR 97229-5442
Phone number: 503-645-3581
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Mailing Address
JASON BOURGEOIS
14600 NW CORNELL RD
PORTLAND, OR 97229-5442
Phone number: 503-645-3581
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