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1215401898
JONATHAN LANDIS
EUGENE, OR
NPI
1215401898
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2019-01-16
Last Update Date
2019-01-16
Business Address
JONATHAN LANDIS
499 W 4TH AVE
EUGENE, OR 97401-2505
Phone number: 541-686-1262
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Mailing Address
JONATHAN LANDIS
499 W 4TH AVE
EUGENE, OR 97401-2505
Phone number: 458-210-7573
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