Individual
JAMES SHEPPARD BRUCE MCMINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2330 NE SISKIYOU ST, PORTLAND, OR 97212-2471
(503) 528-0757
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201242380RN
OR
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
201242380RN
OR
Other
Enumeration date
05/13/2013
Last updated
09/03/2013
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