Individual
MS. JUDITH E. MANCHIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3727 NE MLK JR BLVD, PORTLAND, OR 97212-1112
(503) 775-4931
(503) 788-7285
Mailing address
3727 NE MLK JR BLVD, PORTLAND, OR 97212-1112
(503) 775-4931
(503) 788-7285
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201502583NP-PP
OR
363LF0000X
Family Nurse Practitioner
AP60146972
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538484381
—
OR
05
—
1538484381
—
WA
Enumeration date
04/05/2010
Last updated
06/08/2015
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