Individual
JESUS MONTIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
530 NW 27TH ST, CORVALLIS, OR 97330-5223
(541) 766-6835
(541) 766-6186
Mailing address
2460 NW ROLLING GREEN DR APT 22, CORVALLIS, OR 97330-3776
(503) 957-5763
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/08/2011
Last updated
12/08/2011
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