Individual
MS. AMY SHOOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4764 SE 34TH AVE, PORTLAND, OR 97202-3316
(503) 702-7010
Mailing address
4764 SE 34TH AVE, PORTLAND, OR 97202-3316
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
200741599RN
OR
Other
Enumeration date
04/07/2017
Last updated
04/07/2017
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