Individual
TETYANA HORNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
12519 SW 27TH PL, LAKE OSWEGO, OR 97035-1152
(503) 709-3991
Mailing address
3127 NE SKIDMORE ST, PORTLAND, OR 97211-7173
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
10017929
OR
Other
Enumeration date
06/05/2024
Last updated
06/05/2024
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