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1902130511
JACK CHARLES SKILES
DALLAS, OR
NPI
1902130511
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2009-09-29
Last Update Date
2009-09-29
Business Address
-- JACK CHARLES SKILES
182 S.W. ACADEMY ST. 304 ACADEMY BUILDING
DALLAS, OR 97338-1922
Phone number: 503-831-5971
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Mailing Address
-- JACK CHARLES SKILES
182 SW ACADEMY ST SUITE 304
DALLAS, OR 97338-1922
Phone number: 503-831-5971
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