Individual
PETROS WARITU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
REGISTERED NURSE
Contact information
Practice address
3640 SE 144TH AVE, PORTLAND, OR 97236-2729
(503) 762-9080
Mailing address
2700 NE 17TH ST, GRESHAM, OR 97030-4406
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
200540129RN
OR
Other
Enumeration date
05/18/2018
Last updated
05/18/2018
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