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1902548605
JASON CLARK BATACAN-WILSON
BEND, OR
NPI
1902548605
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Former Name
JASON CLARK WILSON
Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2022-04-12
Last Update Date
2022-04-12
Business Address
JASON CLARK BATACAN-WILSON
1569 SW NANCY WAY
BEND, OR 97702-3234
Phone number: 541-617-0377
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Mailing Address
JASON CLARK BATACAN-WILSON
1569 SW NANCY WAY
BEND, OR 97702-3234
Phone number:
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