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1356076020
JERRY DALE ALLEN
PORTLAND, OR
NPI
1356076020
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
(Licence: OR THW105547)
Enumeration Date
2022-07-18
Last Update Date
2022-07-18
Business Address
JERRY DALE ALLEN
1535 N WILLIAMS AVE
PORTLAND, OR 97227-1885
Phone number: 503-238-2003
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Mailing Address
JERRY DALE ALLEN
232 NW 6TH AVE
PORTLAND, OR 97209-3609
Phone number: 503-294-1681
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