Individual
MICHAEL MANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
5119 NE 57TH AVE, PORTLAND, OR 97218-2584
(503) 215-0850
Mailing address
3424 SE FRANCIS ST, PORTLAND, OR 97202-3348
(503) 446-7843
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
200130387LPN
OR
Other
Enumeration date
01/04/2017
Last updated
01/04/2017
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