Individual
SAMMUS KUIPER ROMEO PREHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
1027 E BURNSIDE ST, PORTLAND, OR 97214-1328
(971) 202-7769
Mailing address
1027 E BURNSIDE ST, PORTLAND, OR 97214-1328
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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