ETHAN LIVELY

PORTLAND, OR
NPI1841908001
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225700000X Massage Therapist
(Licence: OR  27378)
Enumeration Date2022-11-07
Last Update Date2022-11-07
Business Address
ETHAN LIVELY
2149 NE BROADWAY ST
PORTLAND, OR 97232-1580
Phone number: 503-281-0278
Mailing Address
ETHAN LIVELY
18699 NE MARINE DR SLIP C8
PORTLAND, OR 97230-7359
Phone number: 859-802-8089
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