Individual
MR. JASON A. MALCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3550 SE WOODWARD ST, PORTLAND, OR 97202-1552
(503) 234-7532
Mailing address
3550 SE WOODWARD ST, PORTLAND, OR 97202-1552
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
05/31/2007
Last updated
07/08/2007
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