Individual
MRS. SAMANTHA LOUISE MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
17727 E BURNSIDE ST, PORTLAND, OR 97233-4803
(503) 215-9807
Mailing address
17727 E BURNSIDE ST, PORTLAND, OR 97233-4803
(503) 215-9807
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
200840313RN
OR
Other
Enumeration date
09/04/2012
Last updated
09/04/2012
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