Individual
MARY CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
14255 SW BRIGADOON CT STE 80, BEAVERTON, OR 97005-3368
(503) 641-1475
Mailing address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
200741072RN
OR
Other
Enumeration date
12/01/2014
Last updated
12/01/2014
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