Individual
LUIS VILLA JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
4455 NE HIGHWAY 20, CORVALLIS, OR 97330-9695
(541) 758-5900
Mailing address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(503) 234-9591
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10010092
OR
Other
Enumeration date
05/07/2025
Last updated
05/07/2025
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