JACOB MIDDLE DEWILDE

SALEM, OR
NPI1902154255
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2012-08-16
Last Update Date2012-08-16
Business Address
-- JACOB MIDDLE DEWILDE
1118 OAK ST SE
SALEM, OR 97301-4019
Phone number: 503-585-4949
Mailing Address
-- JACOB MIDDLE DEWILDE
1118 OAK ST SE
SALEM, OR 97301-4019
Phone number:
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