Individual
BRANDON JAROD DEYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
12240 NE GLISAN ST, PORTLAND, OR 97230-2117
(503) 488-7720
Mailing address
232 NW 6TH AVENUE, ATTN: BBIS - CREDENTIALING, PORTLAND, OR 97209
(503) 501-5641
(503) 241-7419
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201704506RN
OR
Other
Enumeration date
03/30/2018
Last updated
03/30/2018
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