Individual
ALEX MICHAEL STREETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S.
Contact information
Practice address
13317 SE POWELL BLVD, PORTLAND, OR 97236-3335
(503) 760-9606
(503) 760-9609
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
02/27/2012
Last updated
02/27/2012
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