JONATHON BROADWATER

PORTLAND, OR
NPI1316437189
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2018-05-16
Last Update Date2018-05-16
Business Address
JONATHON BROADWATER
6601 NE 78TH CT STE A3
PORTLAND, OR 97218-2823
Phone number: 503-252-3949
Mailing Address
JONATHON BROADWATER
6601 NE 78TH CT STE A3
PORTLAND, OR 97218-2823
Phone number: 503-252-3949