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Individual

JEDIDIAH HELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
11211 SE 82ND AVE, PORTLAND, OR 97086-7624
(503) 653-5633
Mailing address
12800 NW MARINA WAY, PORTLAND, OR 97231-2311
(443) 752-2347

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
13753
OR

Other

Enumeration date
02/11/2011
Last updated
02/11/2011
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