ALISE FAIRCLOTH

BEAVERTON, OR
NPI1801262589
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy171W00000X Contractor
(Licence: OR  21439)
Enumeration Date2015-08-17
Last Update Date2015-08-17
Business Address
-- ALISE FAIRCLOTH
1921 SW 144TH AVE
BEAVERTON, OR 97005-2356
Phone number: 503-704-6982
Mailing Address
-- ALISE FAIRCLOTH
1921 SW 144TH AVE
BEAVERTON, OR 97005-2356
Phone number: 503-704-6982
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