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1194147454
JACK ROBERT LENNON
PORTLAND, OR
NPI
1194147454
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
146N00000X Emergency Medical Technician, Basic
(Licence: OR 138276)
Enumeration Date
2014-01-06
Last Update Date
2014-01-06
Business Address
Mr. JACK ROBERT LENNON EMT-B
1535 N WILLIAMS AVE
PORTLAND, OR 97227-1885
Phone number: 503-238-2067
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Mailing Address
Mr. JACK ROBERT LENNON EMT-B
232 NW 6TH AVE
PORTLAND, OR 97209-3609
Phone number:
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