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1740971878
ABDURAKHMON RADZHABOV
LAKE OSWEGO, OR
NPI
1740971878
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
311ZA0620X Custodial Care Facility, Adult Care Home
(Licence: OR 519252)
Enumeration Date
2023-05-18
Last Update Date
2023-05-18
Business Address
ABDURAKHMON RADZHABOV
16940 TRACY AVE
LAKE OSWEGO, OR 97035-4558
Phone number: 551-258-7270
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Mailing Address
ABDURAKHMON RADZHABOV
16940 TRACY AVE
LAKE OSWEGO, OR 97035-4558
Phone number: 551-258-7270
Copy