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1083036073
JOHN MCCOLLUM
PORTLAND, OR
NPI
1083036073
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: OR 7727)
Enumeration Date
2014-01-10
Last Update Date
2014-01-10
Business Address
Mr. JOHN MCCOLLUM
4259 NE BROADWAY ST
PORTLAND, OR 97213-1421
Phone number: 503-358-3506
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Mailing Address
Mr. JOHN MCCOLLUM
4259 NE BROADWAY ST
PORTLAND, OR 97213-1421
Phone number: 503-358-3506
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