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1558999664
JACK EZRA KEEGAN
PORTLAND, OR
NPI
1558999664
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Other Name
JESSICA LEE NELSON
Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: OR 200740083RN)
Enumeration Date
2020-04-01
Last Update Date
2020-04-01
Business Address
JACK EZRA KEEGAN
33 NW BROADWAY
PORTLAND, OR 97209-3580
Phone number: 503-228-7134
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Mailing Address
JACK EZRA KEEGAN
232 NW 6TH AVE
PORTLAND, OR 97209-3609
Phone number: 503-294-1681
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