Individual
MS. WINNIFREDA ESPINO LICAYCAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N. P.
Contact information
Practice address
3500 N INTERSTATE AVE, PORTLAND, OR 97227-1196
(503) 285-9321
Mailing address
2058 SE SPRUCE AVE, PORTLAND, OR 97214-5359
(503) 235-2104
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
090007687N3
OR
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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