Individual
MR. MICHAEL G CROCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
2507 CHRISTIE DRIVE, LAKE OSWEGO, OR 97034
(503) 675-2285
(503) 697-3416
Mailing address
726 NE 174TH AVE, PORTLAND, OR 97230-6435
(503) 962-0471
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
200542066RN
OR
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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