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1487279923
JONATHAN DOMINGUEZ
TIGARD, OR
NPI
1487279923
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2020-06-10
Last Update Date
2023-09-01
Business Address
JONATHAN DOMINGUEZ LCSW
11740 SW 68TH PKWY STE 200
TIGARD, OR 97223-9058
Phone number: 503-597-8393
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Mailing Address
JONATHAN DOMINGUEZ LCSW
475 W GLOUCESTER ST
GLADSTONE, OR 97027-2059
Phone number: 406-529-8100
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