Individual
MR. JAKE DANIEL HAROLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
625 NE GALLOWAY ST, MCMINNVILLE, OR 97128-3933
(503) 474-6816
(503) 474-7426
Mailing address
3945 SW 96TH AVE, PORTLAND, OR 97225-2520
(951) 870-9910
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/08/2017
Last updated
08/11/2022
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