JOHNATHON MICHAEL JACOBSEN

GRESHAM, OR
NPI1699363143
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy106S00000X Behavior Technician
(Licence: OR  10212054)
Enumeration Date2021-01-08
Last Update Date2021-01-08
Business Address
JOHNATHON MICHAEL JACOBSEN
912 NE KELLY AVE # 100C
GRESHAM, OR 97030-5629
Phone number: 503-912-5502
Mailing Address
JOHNATHON MICHAEL JACOBSEN
4920 NE GLISAN ST APT 215
PORTLAND, OR 97213-2964
Phone number: 720-633-4818
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