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1710416268
JAKE DANIEL HAROLD
MCMINNVILLE, OR
NPI
1710416268
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Additional Taxonomies
101YP2500X Counselor, Professional
Enumeration Date
2017-06-08
Last Update Date
2022-08-11
Business Address
Mr. JAKE DANIEL HAROLD
625 NE GALLOWAY ST
MCMINNVILLE, OR 97128-3933
Phone number: 503-474-6816
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Mailing Address
Mr. JAKE DANIEL HAROLD
3945 SW 96TH AVE
PORTLAND, OR 97225-2520
Phone number: 951-870-9910
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