Individual
AUSTIN KOURAKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1975 NW 167TH PL, BEAVERTON, OR 97006-4908
(971) 435-0992
Mailing address
1411 NW QUIMBY ST APT 427, PORTLAND, OR 97209-4092
(609) 442-0221
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
28109
OR
Other
Enumeration date
01/31/2024
Last updated
01/31/2024
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