Individual
EVAN DEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
REGISTERED NURSE
Contact information
Practice address
1820 SE 50TH AVE, PORTLAND, OR 97215-3236
(503) 975-6444
Mailing address
1820 SE 50TH AVE, PORTLAND, OR 97215-3236
(503) 975-6444
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
201501092RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201501092RN
—
OR
Enumeration date
05/12/2017
Last updated
05/12/2017
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