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Individual

MICHAEL JAMES STREET

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BSRN

Contact information

Practice address
4531 SE BELMONT ST STE 100, PORTLAND, OR 97215-1675
(541) 965-0722
Mailing address
4531 SE BELMONT ST STE 100, PORTLAND, OR 97215-1675
(541) 965-0722

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
202002804RN
OR

Other

Enumeration date
09/01/2021
Last updated
09/01/2021
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