Individual
BRENT WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4455 NE HWY 20, CORVALLIS, OR 97330
(541) 758-5900
Mailing address
3415 SE POWELL BLVD, PORTLAND, OR 97202
(503) 234-9591
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201505044RN
OR
Other
Enumeration date
03/16/2016
Last updated
03/16/2016
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