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1821290107
JESSE ANTHONY CHAVEZ
CORVALLIS, OR
NPI
1821290107
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
323P00000X Psychiatric Residential Treatment Facility
Enumeration Date
2007-05-31
Last Update Date
2007-07-08
Business Address
Mr. JESSE ANTHONY CHAVEZ
4455 NE HIGHWAY 20
CORVALLIS, OR 97330-9695
Phone number: 541-758-5936
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Mailing Address
Mr. JESSE ANTHONY CHAVEZ
154 NE CONIFER BLVD
CORVALLIS, OR 97330-4677
Phone number: 503-309-5890
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