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1578300810
JACOB VINING
THE DALLES, OR
NPI
1578300810
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
(Licence: OR 112574)
Enumeration Date
2024-07-12
Last Update Date
2024-12-10
Business Address
JACOB VINING
1060 WEBBER ST
THE DALLES, OR 97058-3749
Phone number: 541-296-5452
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Mailing Address
JACOB VINING
1060 WEBBER ST
THE DALLES, OR 97058-3749
Phone number: 541-296-5452
Copy
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