Individual
ALMA SAN JUAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
25050 SE STARK ST STE 265, GRESHAM, OR 97030-3388
(503) 674-1520
Mailing address
25050 SE STARK ST STE 265, GRESHAM, OR 97030-3388
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
202008006
OR
Other
Enumeration date
04/23/2021
Last updated
04/23/2021
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