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Individual

ROGER VAN TUNKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PMHNP

Contact information

Practice address
7105 SW VARNS ST STE 270, PORTLAND, OR 97223-8173
(503) 389-1500
Mailing address
29242 SW VILLEBOIS DR S, WILSONVILLE, OR 97070-7315
(503) 799-2300

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
202010448NP-PP
OR

Other

Enumeration date
11/17/2020
Last updated
11/17/2020
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