JONATHAN TAYLOR SHIELDS

PORTLAND, OR
NPI1477847077
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy372600000X Adult Companion
Additional Taxonomies101Y00000X Counselor
(Licence: OR  101Y00000X)
Enumeration Date2011-06-01
Last Update Date2015-02-23
Business Address
-- JONATHAN TAYLOR SHIELDS QMHA
847 NE 19TH AVE
PORTLAND, OR 97232-2684
Phone number: 971-282-5901
Mailing Address
-- JONATHAN TAYLOR SHIELDS QMHA
5402 NE HOYT ST
PORTLAND, OR 97213-3067
Phone number: 971-282-5901
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