Individual
MISS ELAINE KAREN WILLBANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
14314 SW ALLEN BLVD, 313, BEAVERTON, OR 97005-4403
(503) 349-2401
Mailing address
14314 SW ALLEN BLVD, 313, BEAVERTON, OR 97005-4403
(503) 349-2401
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
095000623RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
611278
DHS MFCU
OR
Enumeration date
08/19/2008
Last updated
08/19/2008
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