LASHAUNDA LOUISE JACKSON

PORTLAND, OR
NPI1326186271
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy320800000X Community Based Residential Treatment Facility, Mental Illness
Additional Taxonomies171M00000X Case Manager/Care Coordinator
Enumeration Date2007-02-02
Last Update Date2009-12-14
Business Address
-- LASHAUNDA LOUISE JACKSON
509 NE ALBERTA ST
PORTLAND, OR 97211-3976
Phone number: 503-249-7767
Mailing Address
-- LASHAUNDA LOUISE JACKSON
12942 SE MITCHELL ST
PORTLAND, OR 97236-4151
Phone number: 503-754-3088