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1548894108
MICHAEL A KOSTIN
GRESHAM, OR
NPI
1548894108
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 023412)
Enumeration Date
2020-02-23
Last Update Date
2020-02-23
Business Address
MICHAEL A KOSTIN
3333 SW MILLER PL
GRESHAM, OR 97080-5500
Phone number: 503-839-5335
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Mailing Address
MICHAEL A KOSTIN
3333 SW MILLER PL
GRESHAM, OR 97080-5500
Phone number: 503-839-5335
Copy
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