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Individual

ROBERT RICHARDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
412 SW 12TH AVE, PORTLAND, OR 97205-2329
(503) 228-7134
Mailing address
232 NW 6TH AVE, PORTLAND, OR 97209-3609
(503) 200-3923

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary

Other

Enumeration date
09/27/2011
Last updated
09/27/2011
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