Individual
ABIGAIL ANNIE BUCKLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2740 SE POWELL BLVD, PORTLAND, OR 97202
(503) 688-2616
Mailing address
907 FULTON ST, NEWBERG, OR 97132-1712
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/09/2018
Last updated
11/28/2018
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