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1629859707
JESSE RAINER BLOODGOOD
PORTLAND, OR
NPI
1629859707
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Former Name
CARMEN MARIE ELLINGSWORTH
Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2023-10-13
Last Update Date
2023-10-13
Business Address
JESSE RAINER BLOODGOOD
13317 SE POWELL BLVD
PORTLAND, OR 97236-3335
Phone number: 503-763-9606
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Mailing Address
JESSE RAINER BLOODGOOD
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number:
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