STANISLAV KUKUSHKIN

PORTLAND, OR
NPI1275082067
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225700000X Massage Therapist
(Licence: OR  21741)
Enumeration Date2016-09-22
Last Update Date2016-09-22
Business Address
-- STANISLAV KUKUSHKIN
17221 SE DIVISION ST
PORTLAND, OR 97236
Phone number: 503-760-0778
Mailing Address
-- STANISLAV KUKUSHKIN
17221 SE DIVISION ST
PORTLAND, OR 97236
Phone number: 503-760-0778