Individual
DORIS IFEOMA AGU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, MSN, MPH, PMHNP
Contact information
Practice address
5441 S MACADAM AVE STE A, PORTLAND, OR 97239-6106
(503) 922-1818
(503) 922-1238
Mailing address
5441 S MACADAM AVE STE A, PORTLAND, OR 97239-6106
(503) 922-1238
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
202004180NP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
95015565
CA
Other
Enumeration date
06/04/2020
Last updated
12/29/2025
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