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1104480334
SHELBY J WAKE
PORTLAND, OR
NPI
1104480334
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
372600000X Adult Companion
Enumeration Date
2019-04-23
Last Update Date
2019-04-23
Business Address
SHELBY J WAKE
847 NE 19TH AVE STE 100
PORTLAND, OR 97232-2684
Phone number: 503-238-0769
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Mailing Address
SHELBY J WAKE
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number:
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