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1649641812
JACK KEENAN
PORTLAND, OR
NPI
1649641812
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2015-10-14
Last Update Date
2016-02-18
Business Address
JACK KEENAN
3530 SE 136TH AVE APT 5
PORTLAND, OR 97236-2958
Phone number: 503-719-4535
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Mailing Address
JACK KEENAN
3587 HEATHROW WAY
MEDFORD, OR 97504-4004
Phone number: 347-406-2922
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