Individual
RYAN LEROY CUMMINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7593
(503) 494-4324
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7593
(503) 494-4324
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
201041424RN
OR
363LF0000X
Family Nurse Practitioner
Primary
201810332NP-PP
OR
Other
Enumeration date
11/08/2018
Last updated
02/22/2022
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