Individual
RICHARD T WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ANP
Contact information
Practice address
6350 NE HALSEY ST, PORTLAND, OR 97213-4720
(503) 215-2669
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
084054476N3
OR
363LA2200X
Adult Health Nurse Practitioner
Primary
1134151822
OR
Other
Enumeration date
07/06/2006
Last updated
02/16/2021
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