Individual
LUIS OLIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11035 NE SANDY BLVD, PORTLAND, OR 97220-2553
(503) 258-4200
Mailing address
11035 NE SANDY BLVD, PORTLAND, OR 97220-2553
(503) 258-4200
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
7783121
OR
Other
Enumeration date
12/14/2015
Last updated
12/14/2015
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