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1225480619
JORDAN ISAIAH PANTHER
CORVALLIS, OR
NPI
1225480619
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103K00000X Behavior Analyst
Enumeration Date
2016-07-08
Last Update Date
2016-07-08
Business Address
Mr. JORDAN ISAIAH PANTHER
4455 NE HIGHWAY 20
CORVALLIS, OR 97330-9695
Phone number: 541-758-5900
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Mailing Address
Mr. JORDAN ISAIAH PANTHER
520 MAPLE ST
AUMSVILLE, OR 97325-8954
Phone number: 503-510-7872
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