James D Heidrick RESIDENTIAL COUNCLER

NPI 1376680595 - Adult Companion - 372600000X

NPI Details
NPI 1376680595
Gender Male
Enumeration Date 01/30/2007
Last Updated 10/21/2014
Entity Type Individual
Active Over 10 years ago
Practice Location
2330 NE SISKIYOU ST
PORTLAND OR, 97212-2471, US
Phone (503) 528-0757
Fax
Business Location
PO BOX 8459
PORTLAND OR, 97207-8459, US
Phone (503) 238-0769
Fax
Toxanomy
Taxonomy Code 372600000X
License State
License Number
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According to our database, Mr. James D Heidrick RESIDENTIAL COUNCLER NPI is 1376680595, taxonomy code is 372600000X James D Heidrick RESIDENTIAL COUNCLER physically located at 2330 Ne Siskiyou St, Portland OR, 97212-2471. NPI Number James D Heidrick RESIDENTIAL COUNCLER has the Individual type.

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1376680595 NPI number is provided on an as is basis without warranty of any kind. 1376680595 is maintained by the National Plan & Provider Enumeration System. The contents of James D Heidrick RESIDENTIAL COUNCLER are for informational purposes only.