Individual
MICHAEL PAUL RICHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
326 SE 76TH AVE, PORTLAND, OR 97215-1468
(503) 225-3198
Mailing address
1802 SE 12TH AVE APT 5, PORTLAND, OR 97214-4898
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
07/10/2007
Last updated
07/10/2007
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