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1023642394
JACK L GAGNON
PORTLAND, OR
NPI
1023642394
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2020-02-26
Last Update Date
2020-02-26
Business Address
JACK L GAGNON
13317 SE POWELL BLVD
PORTLAND, OR 97236-3335
Phone number: 503-760-9606
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Mailing Address
JACK L GAGNON
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number:
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