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1508381914
HUSANI H JACKSON
CORVALLIS, OR
NPI
1508381914
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2017-08-07
Last Update Date
2017-08-07
Business Address
HUSANI H JACKSON
4455 NE HIGHWAY 20
CORVALLIS, OR 97330-9695
Phone number: 503-234-9591
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Mailing Address
HUSANI H JACKSON
4455 NE HIGHWAY 20
CORVALLIS, OR 97330-9695
Phone number:
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