JACK R AGEN

GLADSTONE, OR
NPI1902960362
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YP2500X Counselor, Professional
(Licence: OR  C1077)
Enumeration Date2006-12-20
Last Update Date2007-07-09
Business Address
-- JACK R AGEN MA
880 82ND DR
GLADSTONE, OR 97027-1803
Phone number: 503-659-5515
Mailing Address
-- JACK R AGEN MA
PO BOX 82819
PORTLAND, OR 97282-0819
Phone number: 503-233-5405