Individual
MR. PRINCE ROLAND AGBONZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2817 NE 156TH AVE, PORTLAND, OR 97230-5101
(503) 891-4266
(503) 284-4067
Mailing address
2817 NE 156TH AVE, PORTLAND, OR 97230-5101
(503) 891-4266
(503) 284-4067
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
374U00000X
OR
Other
Enumeration date
04/08/2010
Last updated
04/08/2010
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