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Individual
JUSTIN MOTT
Active
Individual
JUSTIN MOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, MSN
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
200940224RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
936002307
MARION COUNTY
OR
Enumeration date
06/01/2017
Last updated
06/01/2017
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