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Valentin P Burlachenko

Adult Companion in Portland, OR. Individual provider (NPI-1).

NPI number1790097152
StatusActive
Last updated in NPPESJul 13, 2010

Details

NPI
1790097152
Entity type
Individual (NPI-1)
Name
Valentin P Burlachenko
Sex
Male
Sole proprietor
Yes
Enumeration date
Jul 13, 2010
Last updated
Jul 13, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
372600000X Adult Companion––Yes

Practice location

847 Ne 19th Ave
Suite 100
Portland, OR 97232-2684

Phone 503-238-0769

Mailing address

Po Box 8459
Portland, OR 97207-8459

Phone 503-238-0769

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