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1154063980
SCOTT KEVIN MICHAEL SHAKAL
PORTLAND, OR
NPI
1154063980
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-04-12
Last Update Date
2022-04-12
Business Address
SCOTT KEVIN MICHAEL SHAKAL
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3098
Phone number: 503-494-8211
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Mailing Address
SCOTT KEVIN MICHAEL SHAKAL
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3098
Phone number: 503-494-8211
Copy
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