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1851907018
BLAKE WP FRASER
PORTLAND, OR
NPI
1851907018
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 26427)
Enumeration Date
2020-09-22
Last Update Date
2024-02-01
Business Address
BLAKE WP FRASER CMT
1125 SE DIVISION ST STE 204
PORTLAND, OR 97202-2567
Phone number: 682-622-6602
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Mailing Address
BLAKE WP FRASER CMT
1125 SE DIVISION ST STE 204
PORTLAND, OR 97202-2567
Phone number: 682-622-6602
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