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1023512233
ANDREW RUSSELL VAN DER WERF
PORTLAND, OR
NPI
1023512233
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 23850)
Enumeration Date
2018-03-21
Last Update Date
2018-03-21
Business Address
ANDREW RUSSELL VAN DER WERF LMT
2526 NE 15TH AVE
PORTLAND, OR 97212-4222
Phone number: 503-288-7668
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Mailing Address
ANDREW RUSSELL VAN DER WERF LMT
12600 SE HAROLD ST
PORTLAND, OR 97236-4225
Phone number: 775-400-6619
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