Individual
JASON VANCE GERMANY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1312 SW WASHINGTON ST, PORTLAND, OR 97205-2327
(503) 535-1192
Mailing address
PO BOX 3007, PORTLAND, OR 97208-3007
(360) 931-0391
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000000000
OR
Other
Enumeration date
06/05/2014
Last updated
06/05/2014
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