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1710604517
JOHNATHAN ANDREW KRUG
PORTLAND, OR
NPI
1710604517
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 25956)
Enumeration Date
2022-10-21
Last Update Date
2022-10-21
Business Address
Mr. JOHNATHAN ANDREW KRUG
2149 NE BROADWAY ST
PORTLAND, OR 97232-1580
Phone number: 503-281-0278
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Mailing Address
Mr. JOHNATHAN ANDREW KRUG
3119 NE 65TH AVE
PORTLAND, OR 97213-4535
Phone number: 503-995-8158
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