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1376001792
JORDAN ALEXANDER NILES
PORTLAND, OR
NPI
1376001792
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
(Licence: OR 1245624253)
Enumeration Date
2019-03-05
Last Update Date
2019-03-05
Business Address
JORDAN ALEXANDER NILES
805 SE 151ST AVE
PORTLAND, OR 97233-2916
Phone number: 971-271-7270
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Mailing Address
JORDAN ALEXANDER NILES
333 NE 146TH AVE APT 210
PORTLAND, OR 97230-4273
Phone number: 503-753-3194
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