Individual
VALERIY IGUMNOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
847 NE 19TH AVE, SUITE 100, PORTLAND, OR 97232-2684
(503) 238-0769
(503) 552-6208
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
(503) 552-6208
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201040792RN
OR
171M00000X
Case Manager/Care Coordinator
201040792RN
OR
Other
Enumeration date
12/15/2010
Last updated
03/11/2014
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