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Individual

RAUL DANIEL COVACIU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6416 SE JACK RD, MILWAUKIE, OR 97222-2830
(503) 927-0489
Mailing address
6416 SE JACK RD, MILWAUKIE, OR 97222-2830
(503) 927-0489

Taxonomy

Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
519218
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
519218
OR
Enumeration date
01/26/2021
Last updated
01/26/2021
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