JUAN MATA

FAIRVIEW, OR
NPI1790563864
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence:   professionallicense)
Enumeration Date2023-09-19
Last Update Date2025-08-19
Business Address
JUAN MATA
1945 NE 205TH AVE
FAIRVIEW, OR 97024-9622
Phone number: 503-661-8050
Mailing Address
JUAN MATA
3587 HEATHROW WAY
MEDFORD, OR 97504-4004
Phone number: 541-858-8170
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