Individual
MISS BETH NOEL HIGGINBOTHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2222 N KILPATRICK ST, PORTLAND, OR 97217-6820
(417) 576-0452
Mailing address
2222 N KILPATRICK ST, PORTLAND, OR 97217-6820
(417) 576-0452
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
200630071LPN
OR
Other
Enumeration date
10/07/2008
Last updated
10/07/2008
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