Individual
JASON GILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
8770 SW SCOFFINS ST, TIGARD, OR 97223-6226
(503) 684-1424
(503) 684-1425
Mailing address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
(503) 645-3581
(503) 533-0152
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3718
OR
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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