Zachary Glen Gordon Patrick-riley

NPI 1912345174 - Adult Companion - 372600000X

NPI Details
NPI 1912345174
Gender Male
Enumeration Date 06/10/2013
Last Updated 06/10/2013
Entity Type Individual
Active Over 5 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
Remove 1912345174 NPI Number
 

According to our database, Zachary Glen Gordon Patrick-riley NPI is 1912345174, taxonomy code is 372600000X Zachary Glen Gordon Patrick-riley physically located at 2330 Ne Siskiyou St, Portland OR, 97212-2471. NPI Number Zachary Glen Gordon Patrick-riley has the Individual type.

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1912345174 NPI number is provided on an as is basis without warranty of any kind. 1912345174 is maintained by the National Plan & Provider Enumeration System. The contents of Zachary Glen Gordon Patrick-riley are for informational purposes only.