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1942894290
ETHAN W TREVINO
PORTLAND, OR
NPI
1942894290
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 26242)
Enumeration Date
2021-02-26
Last Update Date
2021-02-26
Business Address
ETHAN W TREVINO LMT
5253 NE SANDY BLVD
PORTLAND, OR 97213-2562
Phone number: 503-893-5131
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Mailing Address
ETHAN W TREVINO LMT
64770 BIG BUCK DR
DEER ISLAND, OR 97054-9418
Phone number: 801-686-3612
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