Most Relevant Information
Provider Data
| NPI Number: | 1003430802 |
| Provider Name: | JASON PRINZ BLUME |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | IN-10208105 |
Most Important Dates
| Enumeration Date: | 06/08/2020 |
| Last Updated: | 06/08/2020 |
Provider Practice Location
750 NW CHARBONNEAU ST.
SUITE 201
BEND
OR
97701
Practice Location Phone/Fax
| Phone: | 5415915669 |
| Fax: |
Provider Mailing Location
750 NW CHARBONNEAU ST
SUITE 201
BEND
OR
97701
Provider Mailing Phone/Fax
| Phone: | 5415915669 |
| Fax: |