Individual
RICHARD JORDAN DELAVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
16770 SW EDY RD STE 102A, SHERWOOD, OR 97140-9679
(503) 216-9600
(503) 216-9650
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201909698NP-PP
OR
Other
Enumeration date
12/18/2019
Last updated
10/13/2020
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