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1285001305
ANTHONY MICHAEL BLAKE
PORTLAND, OR
NPI
1285001305
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
372600000X Adult Companion
Enumeration Date
2015-08-24
Last Update Date
2015-08-28
Business Address
Mr. ANTHONY MICHAEL BLAKE
847 NE 19TH AVE
PORTLAND, OR 97232-2684
Phone number: 520-704-3749
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Mailing Address
Mr. ANTHONY MICHAEL BLAKE
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number:
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