Individual
CHARLES DWYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2810 SE 71ST AVENUE, PORTLAND, OR 97206-1127
(503) 771-8733
Mailing address
2810 SE 71ST AVE, PORTLAND, OR 97206-1127
(503) 771-8733
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
099000230RN
OR
Other
Enumeration date
09/18/2008
Last updated
09/18/2008
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