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1154887180
MIDORI PORTILLO
PORTLAND, OR
NPI
1154887180
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
Enumeration Date
2019-02-14
Last Update Date
2019-02-14
Business Address
MIDORI PORTILLO
4410 NE 80TH AVE
PORTLAND, OR 97218-4216
Phone number: 408-250-4744
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Mailing Address
MIDORI PORTILLO
4410 NE 80TH AVE
PORTLAND, OR 97218-4216
Phone number: 408-250-4744
Copy
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