Individual
BRYAN LATTANZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
12612 SE STARK ST BLDG M, PORTLAND, OR 97233-1058
(503) 906-9995
(503) 597-7000
Mailing address
12612 SE STARK ST BLDG M, PORTLAND, OR 97233-1058
(503) 906-9995
(503) 597-7000
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OR
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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