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1851950331
ISAIAH JACKSON
LAKE OSWEGO, OR
NPI
1851950331
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2019-06-10
Last Update Date
2019-06-10
Business Address
ISAIAH JACKSON
2507 CHRISTIE DR
LAKE OSWEGO, OR 97034
Phone number: 503-635-3416
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Mailing Address
ISAIAH JACKSON
PO BOX 368
MARYLHURST, OR 97036-0368
Phone number:
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