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Search › Oregon › 172V00000X

Jake Gongora

NPI 1205466018 · on the registry since 2020

Practice

Address
4890 32nd Ave Se
Salem, OR 97317
Phone
(503) 588-5647
Fax
(503) 779-1992
Organisation at this address
Christian Community Placement Center
Christian Community Placement Center
Inferred from a shared address, not stated in the registry.
Clinicians at this address
68

Registry record

Primary taxonomy
172V00000X
172V00000X
Sex
Male
Record last updated
2020-01-21

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon