Individual
KEVIN MUNSON O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, FNP-C, APRN
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8311
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8562
(503) 418-5505
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
202003236RN
OR
363LF0000X
Family Nurse Practitioner
Primary
202202595NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202003236RN
RN LICENSE
OR
Enumeration date
08/08/2020
Last updated
07/12/2022
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