Individual
RICHARD ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4531 SE BELMONT ST, PORTLAND, OR 97215-1675
(503) 215-6556
Mailing address
4531 SE BELMONT ST, PORTLAND, OR 97215-1675
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201030148LPN
OR
Other
Enumeration date
03/09/2016
Last updated
03/09/2016
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