Individual
JORDON HEYNOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
55 NE GRAND AVE, PORTLAND, OR 97232-2968
(971) 230-7653
Mailing address
55 NE GRAND AVE, PORTLAND, OR 97232-2968
(971) 230-7653
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
02/08/2016
Last updated
02/08/2016
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