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1821444316
MICHAEL BACA
PORTLAND, OR
NPI
1821444316
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
372600000X Adult Companion
Enumeration Date
2016-05-13
Last Update Date
2016-05-13
Business Address
-- MICHAEL BACA
847 NE 19TH AVE
PORTLAND, OR 97232-2684
Phone number: 503-238-0769
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Mailing Address
-- MICHAEL BACA
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number:
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