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1578800405
IAN DOUGHERTY
PORTLAND, OR
NPI
1578800405
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 18078)
Enumeration Date
2013-01-11
Last Update Date
2013-01-11
Business Address
-- IAN DOUGHERTY
2037 N WILLIAMS AVE
PORTLAND, OR 97227-1929
Phone number: 503-287-3813
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Mailing Address
-- IAN DOUGHERTY
375 NE SHAVER ST APT 608
PORTLAND, OR 97212-1080
Phone number:
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