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1992979942
MATT GLENN PHILLIPS
PORTLAND, OR
NPI
1992979942
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
372600000X Adult Companion
Enumeration Date
2008-04-21
Last Update Date
2008-04-21
Business Address
MATT GLENN PHILLIPS
509 NE ALBERTA ST
PORTLAND, OR 97211-3976
Phone number: 503-249-7767
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Mailing Address
MATT GLENN PHILLIPS
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number: 503-238-0769
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