JASON RICHARD COSTELLO

PORTLAND, OR
NPI1407997679
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171100000X Acupuncturist
(Licence: OR  AC00987)
Enumeration Date2007-02-09
Last Update Date2007-07-08
Business Address
Mr. JASON RICHARD COSTELLO LAc
909 SW 12TH AVE. 111
PORTLAND, OR 97205-2070
Phone number: 310-993-9429
Mailing Address
Mr. JASON RICHARD COSTELLO LAc
909 SW 12TH AVE. 111
PORTLAND, OR 97205-2070
Phone number: 310-993-9429
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