Individual
SHANE DWAYNE MURRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8728 N WILBUR AVE, PORTLAND, OR 97217-7032
(541) 220-3672
Mailing address
8728 N WILBUR AVE, PORTLAND, OR 97217-7032
(541) 220-3672
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
201310126CNA
OR
Other
Enumeration date
06/24/2015
Last updated
06/24/2015
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