Individual
JUAN ANTONIO VALLEJO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4101 NE DIVISION ST, GRESHAM, OR 97030-4617
(503) 729-2152
Mailing address
4101 NE DIVISION ST, GRESHAM, OR 97030-4617
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/14/2023
Last updated
03/14/2023
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