TRISTAN LANE HERBERT

PORTLAND, OR
NPI1093930026
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Additional Taxonomies372600000X Adult Companion
Enumeration Date2007-04-16
Last Update Date2007-09-15
Business Address
-- TRISTAN LANE HERBERT
1232 NW 23RD AVE
PORTLAND, OR 97210-2906
Phone number: 503-227-3450
Mailing Address
-- TRISTAN LANE HERBERT
3123 SW DOLPH CT #1
PORTLAND, OR 97219
Phone number: 502-223-1117
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