DAKOTA MICHEAL LAKE

SALEM, OR
NPI1407628845
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: OR  A13188)
Enumeration Date2023-10-30
Last Update Date2023-10-30
Business Address
Mr. DAKOTA MICHEAL LAKE CSWA
2355 STATE ST STE 101
SALEM, OR 97301-4541
Phone number: 971-415-5755
Mailing Address
Mr. DAKOTA MICHEAL LAKE CSWA
5881 N MONTANA AVE APT 303
PORTLAND, OR 97217-4681
Phone number: 616-821-6584
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