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1275082067
STANISLAV KUKUSHKIN
PORTLAND, OR
NPI
1275082067
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 21741)
Enumeration Date
2016-09-22
Last Update Date
2016-09-22
Business Address
-- STANISLAV KUKUSHKIN
17221 SE DIVISION ST
PORTLAND, OR 97236
Phone number: 503-760-0778
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Mailing Address
-- STANISLAV KUKUSHKIN
17221 SE DIVISION ST
PORTLAND, OR 97236
Phone number: 503-760-0778
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