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1063243582
SAMUEL JACKSON LISIESKI
PORTLAND, OR
NPI
1063243582
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Entity Type
Individual
Gender
N/A
Sole Proprietor ?
No
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 28282)
Enumeration Date
2024-08-08
Last Update Date
2024-08-08
Business Address
SAMUEL JACKSON LISIESKI LMT
7925 SE STARK ST
PORTLAND, OR 97215-2341
Phone number: 503-785-9914
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Mailing Address
SAMUEL JACKSON LISIESKI LMT
326 NE 78TH AVE
PORTLAND, OR 97213-6339
Phone number: 512-230-7416
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