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1851643266
EDWARD WICKWIRE
PORTLAND, OR
NPI
1851643266
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 8033)
Enumeration Date
2012-10-09
Last Update Date
2012-10-09
Business Address
-- EDWARD WICKWIRE LMT
917 SW OAK ST STE 209
PORTLAND, OR 97205-2805
Phone number: 503-702-3151
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Mailing Address
-- EDWARD WICKWIRE LMT
917 SW OAK ST STE 209
PORTLAND, OR 97205-2805
Phone number: 503-702-3151
Copy
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