NATHAN FASOLD

PORTLAND, OR
NPI1528200847
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy163WP0808X Registered Nurse, Psych/Mental Health
(Licence: OR  200842345RN)
Additional Taxonomies372600000X Adult Companion
Enumeration Date2009-04-01
Last Update Date2010-11-15
Business Address
-- NATHAN FASOLD
5029 NE KILLINGSWORTH ST
PORTLAND, OR 97218
Phone number: 503-402-8117
Mailing Address
-- NATHAN FASOLD
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number: 503-238-0769