Mr. Jake Gongora
Mr. Jake Gongora is a Community Health Worker in Salem, Oregon. Registered with an NPI since 2020.
- In the registry since
- 2020
Practice location Address checks out
4890 32nd Ave SESalem, OR 97317-9350
Phone: (503) 588-5647
Fax: (503) 779-1992
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Community Health Worker (primary) | Taxonomy 172V00000X |
|---|
Record details
| NPI number | 1205466018 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | January 21, 2020 |
| Last updated in NPPES | January 21, 2020 |
| Certification date | January 21, 2020 |
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