JOHN KENNAN NOVACK

BEAVERTON, OR
NPI1831208529
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy156FX1800X Technician/Technologist, Optician
(Licence: WA  dt100005673)
Enumeration Date2006-08-29
Last Update Date2007-07-08
Business Address
Mr. JOHN KENNAN NOVACK
4855 SW WESTERN AVE
BEAVERTON, OR 97005-3460
Phone number: 503-643-7565
Mailing Address
Mr. JOHN KENNAN NOVACK
15100 SE GLADSTONE DR
PORTLAND, OR 97236-2445
Phone number: 503-762-4265
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