Individual
MRS. ILEANA KEREZSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3519 SE CORA DR, PORTLAND, OR 97202-3332
(503) 235-0852
(503) 239-1888
Mailing address
3519 SE CORA DR, PORTLAND, OR 97202-3332
(503) 235-0852
(503) 239-1888
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
572854
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
572854
—
OR
Enumeration date
01/04/2009
Last updated
01/04/2009
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