Individual
JACOB AARON WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5330 NE PRESCOTT ST, PORTLAND, OR 97218-2158
(503) 288-6585
Mailing address
25117 SW PARKWAY AVE, STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
03/28/2017
Last updated
03/28/2017
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