Individual
MIKHAIL GOVSHIEVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LD
Contact information
Practice address
9045 SW BARBUR BLVD. SUIT 117, PORTLAND, OR 97219
(503) 380-7306
Mailing address
4901 PARKVIEW DR APT P, LAKE OSWEGO, OR 97035-4472
(503) 380-7306
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DTO10154441
OR
Other
Enumeration date
08/29/2014
Last updated
09/19/2014
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