Individual
CONSTANCE LYNN COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
500 NE MULTNOMAH ST, PORTLAND, OR 97232-2023
(503) 813-4205
Mailing address
PO BOX 186, CLACKAMAS, OR 97015-0186
(503) 706-3455
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
078041708RN
OR
Other
Enumeration date
05/27/2008
Last updated
05/27/2008
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