Individual
JACOB LAZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 NE MULTNOMAH ST STE 275, PORTLAND, OR 97232-4103
(503) 729-1380
Mailing address
700 NE MULTNOMAH ST STE 275, PORTLAND, OR 97232-4103
(503) 729-1380
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
A14962
OR
Other
Enumeration date
03/29/2022
Last updated
03/07/2024
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