JOHNNIE SAN NICOLAS

PORTLAND, OR
NPI1760079347
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225700000X Massage Therapist
(Licence: OR  26117)
Enumeration Date2020-12-29
Last Update Date2020-12-29
Business Address
JOHNNIE SAN NICOLAS
3241 NE BROADWAY ST
PORTLAND, OR 97232-1814
Phone number: 503-282-8582
Mailing Address
JOHNNIE SAN NICOLAS
3241 NE BROADWAY ST
PORTLAND, OR 97232-1814
Phone number: 503-282-8582