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1205593191
SHANE STARK
PORTLAND, OR
NPI
1205593191
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 19432)
Enumeration Date
2021-11-26
Last Update Date
2021-11-26
Business Address
SHANE STARK Medical Massage LMT
6700 E BURNSIDE ST
PORTLAND, OR 97215-1051
Phone number: 503-627-7243
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Mailing Address
SHANE STARK Medical Massage LMT
6700 E BURNSIDE ST
PORTLAND, OR 97215-1051
Phone number: 503-627-7243
Copy
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