LARRY RUSSOCK

PORTLAND, OR
NPI1538480306
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy372600000X Adult Companion
Enumeration Date2010-06-16
Last Update Date2010-06-16
Business Address
-- LARRY RUSSOCK
847 NE 19TH AVE
PORTLAND, OR 97232-2684
Phone number: 503-238-0769
Mailing Address
-- LARRY RUSSOCK
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number: 503-238-0769
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