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1215754387
JAKE SULLIVAN
PORTLAND, OR
NPI
1215754387
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-09-20
Last Update Date
2024-09-20
Business Address
JAKE SULLIVAN
1235 SE MORRISON ST
PORTLAND, OR 97214-2462
Phone number: 503-746-3373
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Mailing Address
JAKE SULLIVAN
7346 NE SANDY BLVD
PORTLAND, OR 97213-5775
Phone number: 503-746-3373
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