CHAKA J. BLOODSAW

NEHALEM, OR
NPI1386929883
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy172M00000X Mechanotherapist
(Licence: OR  16671)
Additional Taxonomies172M00000X Mechanotherapist
(Licence: WA  60134001)
Enumeration Date2011-10-15
Last Update Date2011-10-15
Business Address
Mr. CHAKA J. BLOODSAW LMT #16671
36450 N. FORK RD.
NEHALEM, OR 97131
Phone number: 503-368-7964
Mailing Address
Mr. CHAKA J. BLOODSAW LMT #16671
PO BOX 351
NEHALEM, OR 97131-0351
Phone number: 503-368-7964