Individual
KENNETH JASPERSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA
Contact information
Practice address
4101 NE DIVISION ST # 100, GRESHAM, OR 97030-4617
(503) 666-3808
(503) 666-6835
Mailing address
12031 SE MAIN ST, PORTLAND, OR 97216-3963
(503) 666-3808
(503) 666-6835
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/22/2008
Last updated
10/22/2008
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