Individual
JESSICA GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1245 SW GROVER ST APT 204, PORTLAND, OR 97239-3083
(503) 516-5485
Mailing address
1245 SW GROVER ST APT 204, PORTLAND, OR 97239-3083
(503) 516-5485
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
2759389
OR
Other
Enumeration date
01/11/2023
Last updated
01/11/2023
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