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1215272893
JONATHAN SCOTT
PORTLAND, OR
NPI
1215272893
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: OR 19382)
Enumeration Date
2012-12-07
Last Update Date
2012-12-07
Business Address
-- JONATHAN SCOTT LMT
6880 SE DIVISION ST
PORTLAND, OR 97206-1269
Phone number: 706-676-7708
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Mailing Address
-- JONATHAN SCOTT LMT
6880 SE DIVISION ST
PORTLAND, OR 97206-1269
Phone number:
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