Individual
JONATHAN LOWELL MALOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
216 NE 10TH ST, MCMINNVILLE, OR 97128-4826
(971) 261-2259
Mailing address
627 NE EVANS ST, MCMINNVILLE, OR 97128-3923
(971) 261-2259
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/27/2019
Last updated
06/27/2019
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