Individual
MICHAEL DESCLOUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
722 NE 162ND AVE, PORTLAND, OR 97230-5760
(503) 408-5016
Mailing address
21505 NE WILLOW GLEN RD, FAIRVIEW, OR 97024-6793
(832) 875-5228
(503) 506-0512
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
201143647RN
OR
Other
Enumeration date
04/20/2012
Last updated
04/20/2012
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