Individual
JOSHUA DAVID JAKLICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3820 SE 26TH AVE, PORTLAND, OR 97202-2923
(503) 238-0769
(503) 552-6208
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
(503) 552-6208
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
02/18/2011
Last updated
02/18/2011
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