JAKE ANTONINI

TIGARD, OR
NPI1063840700
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2013-10-16
Last Update Date2013-10-16
Business Address
-- JAKE ANTONINI
8915 SW CENTER ST
TIGARD, OR 97223-6307
Phone number: 503-726-3698
Mailing Address
-- JAKE ANTONINI
8915 SW CENTER ST
TIGARD, OR 97223-6307
Phone number: 503-726-3698