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1093114407
PHONEVILAY HEUANGSACKDA
PORTLAND, OR
NPI
1093114407
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2014-08-21
Last Update Date
2014-08-21
Business Address
-- PHONEVILAY HEUANGSACKDA
1312 SW WASHINGTON ST
PORTLAND, OR 97205-2327
Phone number: 503-535-1151
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Mailing Address
-- PHONEVILAY HEUANGSACKDA
1232 NE 194TH CT
PORTLAND, OR 97230
Phone number: 503-841-9869
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