JACK AUSTIN PHILLIPS

PORTLAND, OR
NPI1407100902
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy372600000X Adult Companion
Enumeration Date2012-11-05
Last Update Date2012-11-05
Business Address
-- JACK AUSTIN PHILLIPS
5023 NE KILLINGSWORTH ST
PORTLAND, OR 97218-1915
Phone number: 503-284-4249
Mailing Address
-- JACK AUSTIN PHILLIPS
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number: 503-238-0769
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