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Individual

JERALD WILLIAM DRISKELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.N., FNP-C

Contact information

Practice address
2850 SE POWELL VALLEY RD, GRESHAM, OR 97080
(503) 666-5050
Mailing address
PO BOX 3777, PORTLAND, OR 97208

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
200740644RN
OR
163W00000X
Registered Nurse
509631
TX
363L00000X
Nurse Practitioner
Primary
200750068NP
OR
363L00000X
Nurse Practitioner
509631
TX

Other

Enumeration date
06/06/2007
Last updated
09/02/2016
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