JAKE GARDNER HERBERT

PORTLAND, OR
NPI1831831981
Former NameJAKE GARDNER AMES
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2022-04-10
Last Update Date2022-04-10
Business Address
JAKE GARDNER HERBERT DO
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3098
Phone number: 503-494-8211
Mailing Address
JAKE GARDNER HERBERT DO
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3098
Phone number: 503-494-8211
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