Individual
NANCY JANE WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNFA
Contact information
Practice address
10940 SW BARNES RD, PMB 261, PORTLAND, OR 97225-5368
(503) 706-6660
(503) 469-9176
Mailing address
10940 SW BARNES RD, PMB 261, PORTLAND, OR 97225-5368
(503) 706-6660
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
—
OR
Other
Enumeration date
01/19/2007
Last updated
07/08/2007
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