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Individual

MARY JANE OROURKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7405 SE TIBBETTS ST, PORTLAND, OR 97206-1843
(503) 256-1667
Mailing address
7405 SE TIBBETTS, PORTLAND, OR 97206-1843

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6921
OR

Other

Enumeration date
07/09/2008
Last updated
07/09/2008
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