Individual
LAURENT E. O. AVONDSTONDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 220-8262
(503) 731-1035
Mailing address
PSC 482 BOX 1600, FPO, AP 96362-9998
(315) 643-7977
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200350144NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9625955
—
OR
Enumeration date
11/04/2005
Last updated
07/12/2011
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