Organization
BLACK ENTERPRISES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER D BLACK LMT (VICE PRESIDENT)
(808) 280-6470
Entity
Organization
Contact information
Practice address
2610 SE CLINTON ST STE E, PORTLAND, OR 97202-1273
(808) 280-6470
Mailing address
4725 SE SALMON ST UNIT A, PORTLAND, OR 97215-2577
(808) 280-6470
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
02/12/2025
Last updated
02/12/2025
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