PERCIVAL ALIOTH LIEBAT

PORTLAND, OR
NPI1336653492
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy372600000X Adult Companion
Additional Taxonomies167G00000X Licensed Psychiatric Technician
Enumeration Date2017-11-28
Last Update Date2023-10-27
Business Address
PERCIVAL ALIOTH LIEBAT
30 NE MARTIN LUTHER KING JR BLVD
PORTLAND, OR 97232-2941
Phone number: 503-232-1099
Mailing Address
PERCIVAL ALIOTH LIEBAT
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number:
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