JACOB DAVID STARK

PORTLAND, OR
NPI1225863897
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor Mental Health
Enumeration Date2024-09-04
Last Update Date2024-09-04
Business Address
JACOB DAVID STARK
10373 NE HANCOCK ST STE 200
PORTLAND, OR 97220-3873
Phone number: 503-253-6754
Mailing Address
JACOB DAVID STARK
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number: 503-238-0769
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