Individual
MRS. ROSE MARIE TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, ANP
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, L-603, PORTLAND, OR 97239-3011
(503) 494-5626
(503) 494-5627
Mailing address
3181 SW SAM JACKSON PARK RD, L-603, PORTLAND, OR 97239-3011
(503) 494-5626
(503) 494-5627
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
090000307N3 ANP-PP
OR
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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