Individual
GERRYKO R. JAKE CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT INTERN
Contact information
Practice address
1976 GARDEN AVE, EUGENE, OR 97403-1933
(541) 255-1411
(541) 255-1412
Mailing address
1976 GARDEN AVE, EUGENE, OR 97403-1933
(541) 255-1411
(541) 255-1412
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500836101
—
OR
Enumeration date
05/24/2023
Last updated
02/04/2025
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