Individual
SALLY JO NIEDERMEYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5211 NE GLISAN ST BLDG C, PORTLAND, OR 97213-3052
(503) 215-3081
Mailing address
PO BOX 404, GOVERNMENT CAMP, OR 97028-0404
(503) 505-4627
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
080045857RN
OR
Other
Enumeration date
10/06/2016
Last updated
10/06/2016
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