Individual
MARY ELIZABETH AISTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
8605 SE CLATSOP ST, PORTLAND, OR 97266-6511
(503) 784-4174
Mailing address
8605 SE CLATSOP ST, PORTLAND, OR 97266-6511
(503) 784-4174
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201130574LPN
OR
Other
Enumeration date
11/15/2011
Last updated
11/15/2011
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