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1457757999
SHANE AUSTIN SMITH
PORTLAND, OR
NPI
1457757999
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
372600000X Adult Companion
Enumeration Date
2014-11-11
Last Update Date
2014-11-11
Business Address
-- SHANE AUSTIN SMITH
7405 SE 84TH AVE
PORTLAND, OR 97266-5840
Phone number: 503-771-1645
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Mailing Address
-- SHANE AUSTIN SMITH
12248 SE MARKET ST
PORTLAND, OR 97233-1235
Phone number: 503-995-4778
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