Individual
NATHAN MARK JUAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11576 SE 27TH AVE, MILWAUKIE, OR 97222-7719
(503) 305-6943
Mailing address
11576 SE 27TH AVE, MILWAUKIE, OR 97222-7719
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
0118
OR
171M00000X
Case Manager/Care Coordinator
Primary
0118
OR
Other
Enumeration date
08/20/2013
Last updated
08/20/2013
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