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Individual

JEDIDIAH VERNON HANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2330 NE SISKIYOU ST, PORTLAND, OR 97212-2471
(503) 528-0757
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary

Other

Enumeration date
11/11/2022
Last updated
11/11/2022
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Product
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  • Eligibility checks
  • EDI platform