BASILIO ERIBERTO LOPEZ - SOTO

PORTLAND, OR
NPI1043727159
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy372600000X Adult Companion
Enumeration Date2018-01-10
Last Update Date2018-01-10
Business Address
BASILIO ERIBERTO LOPEZ - SOTO
847 NE 19TH AVE STE 100
PORTLAND, OR 97232-2684
Phone number: 503-238-0769
Mailing Address
BASILIO ERIBERTO LOPEZ - SOTO
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number:
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