JACOB KEITH BASSEN

PORTLAND, OR
NPI1790336220
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2019-09-25
Last Update Date2019-09-25
Business Address
JACOB KEITH BASSEN
811 NW 20TH AVE
PORTLAND, OR 97209-1443
Phone number: 503-807-3917
Mailing Address
JACOB KEITH BASSEN
498 SE 10TH AVE
CANBY, OR 97013-8783
Phone number: