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1912458472
ANDREW BAXTER
PORTLAND, OR
NPI
1912458472
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 21103)
Enumeration Date
2016-10-19
Last Update Date
2016-10-19
Business Address
Mr. ANDREW BAXTER
2285 NW JOHNSON ST
PORTLAND, OR 97210-3236
Phone number: 585-469-0420
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Mailing Address
Mr. ANDREW BAXTER
2285 NW JOHNSON ST
PORTLAND, OR 97210-3236
Phone number:
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