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1346464419
CHARLES WILLIAM STREET
BEAVERTON, OR
NPI
1346464419
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: OR 1002)
Enumeration Date
2007-04-12
Last Update Date
2007-07-08
Business Address
Mr. CHARLES WILLIAM STREET Massage Therapist
1060 SW 170TH AVE UNIT 200
BEAVERTON, OR 97006-8089
Phone number: 541-778-0705
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Mailing Address
Mr. CHARLES WILLIAM STREET Massage Therapist
1060 SW 170TH AVE UNIT 200
BEAVERTON, OR 97006-8089
Phone number: 541-778-0705
Copy
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