Individual
CHUKWUEMEKA IBENEME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
847 NE 19TH AVE, 100, PORTLAND, OR 97232-2684
(503) 238-0769
Mailing address
PO BOX 847, PORTLAND, OR 97207-0847
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
201507317RN
OR
Other
Enumeration date
01/24/2017
Last updated
01/24/2017
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