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1528814902
JACOB RAY
COBURG, OR
NPI
1528814902
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR T-24-3929)
Enumeration Date
2024-04-26
Last Update Date
2024-04-26
Business Address
JACOB RAY
1 SERENITY LN
COBURG, OR 97408-9350
Phone number: 541-366-6293
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Mailing Address
JACOB RAY
2924 STARK ST
EUGENE, OR 97404-1843
Phone number: 541-729-9260
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