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1720331366
AUSA PEACOCK
PORTLAND, OR
NPI
1720331366
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 15125)
Enumeration Date
2012-10-19
Last Update Date
2012-10-19
Business Address
-- AUSA PEACOCK LMT
833 SE MAIN ST # 423
PORTLAND, OR 97214-3454
Phone number: 503-583-2872
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Mailing Address
-- AUSA PEACOCK LMT
6326 NE 25TH AVE
PORTLAND, OR 97211-6044
Phone number: 503-583-2872
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