Jacob David Stark
Jacob David Stark is a Mental Health Counselor in Portland, Oregon. Registered with an NPI since 2024.
- In the registry since
- 2024
Practice location Address checks out
10373 NE Hancock St Ste 200Portland, OR 97220-3873
Phone: (503) 253-6754
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Mental Health Counselor (primary) | Taxonomy 101YM0800X |
|---|
Record details
| NPI number | 1225863897 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | September 4, 2024 |
| Last updated in NPPES | September 4, 2024 |
| Certification date | September 4, 2024 |
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