MR. JAKE GONGORA
Community Health Worker
Active
Individual
NPI: 1205466018
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Community Health Worker | 172V00000X | Yes | - |
Frequently Asked Questions
NPI 1205466018 is the National Provider Identifier for MR. JAKE GONGORA, a Community Health Worker provider located in Salem, OR. This NPI was enumerated on January 21, 2020.
MR. JAKE GONGORA practices at 4890 32ND AVE SE, Salem, OR 97317.
Quick Facts
- NPI
- 1205466018
- Type
- Individual
- Enumerated
- Jan 21, 2020
- Last Updated
- Jan 21, 2020
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