Individual
BARBARA JEAN CORDOVA AYALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
727 W BURNSIDE ST, PORTLAND, OR 97209-3514
(503) 228-4533
Mailing address
232 NW 6TH AVE, PORTLAND, OR 97209-3609
(503) 501-5641
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
200830020LPN
OR
Other
Enumeration date
06/28/2019
Last updated
06/28/2019
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