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1043493737
JACOB WHITE
PORTLAND, OR
NPI
1043493737
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2007-12-17
Last Update Date
2007-12-17
Business Address
-- JACOB WHITE
5120 SE 118TH AVE
PORTLAND, OR 97266-3250
Phone number: 503-238-0769
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Mailing Address
-- JACOB WHITE
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number:
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