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1679258677
JAY VILLANUEVA
PORTLAND, OR
NPI
1679258677
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: CO PTA...13101)
Enumeration Date
2023-06-16
Last Update Date
2023-06-16
Business Address
JAY VILLANUEVA
3710 SW US VETERANS HOSPITAL RD
PORTLAND, OR 97239-2964
Phone number: 503-220-8262
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Mailing Address
JAY VILLANUEVA
BLDG 834 SIXTH ST BOX 2518
LITTLE ROCK AFB, AR 72099-0001
Phone number:
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