Individual ProviderJeffrey DuklethSocial WorkerBehavioral Health & Social Service ProvidersPractice Address3415 SE Powell Blvd, Portland, OR 97202-3371(503) 234-9591PECOS EnrollmentBased on the most recent information from CMS, provider Jeffrey Dukleth does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1114271491Provider TypeIndividualFull NameDukleth, JeffreyTitleMr.GenderMaleSole ProprietorNoEnumeration Date11/7/2012Last Updated11/7/2012Contact InformationPractice LocationPractice Address3415 SE Powell Blvd, Portland, OR 97202-3371Phone(503) 234-9591FaxUnlisted FaxMailing LocationMailing Address3415 SE Powell Blvd, Portland, OR 97202-3371PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer