JASON THEDSOMBANDITH

BAKER CITY, OR
NPI1568274223
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  T-23-3406)
Enumeration Date2025-01-21
Last Update Date2025-01-31
Business Address
JASON THEDSOMBANDITH
3600 13TH ST
BAKER CITY, OR 97814-1346
Phone number: 541-388-6195
Mailing Address
JASON THEDSOMBANDITH
3425 13TH ST
BAKER CITY, OR 97814-1340
Phone number: 541-523-7400