Individual
BEVERLY SUE PLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2155 NW 153RD PL, BEAVERTON, OR 97006-5635
(503) 690-8136
Mailing address
2155 NW 153RD PL, BEAVERTON, OR 97006-5635
(503) 690-8136
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
200841487RN
OR
163W00000X
Registered Nurse
RN60096906
WA
Other
Enumeration date
03/09/2010
Last updated
03/09/2010
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