Individual
JAKE MICHAEL JANOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
(503) 645-3581
Mailing address
16171 NW SPARTAN WAY APT 135, PORTLAND, OR 97229-9230
(503) 440-3990
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
VC601D4K
—
OR
Enumeration date
04/18/2017
Last updated
04/18/2017
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