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1366749848
KELLY T FUNK
PORTLAND, OR
NPI
1366749848
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
372600000X Adult Companion
Enumeration Date
2011-02-18
Last Update Date
2011-02-18
Business Address
-- KELLY T FUNK
2330 NE SISKIYOU ST
PORTLAND, OR 97212-2471
Phone number: 503-238-0769
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Mailing Address
-- KELLY T FUNK
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number: 503-238-0769
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