Individual
PETER MWANGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
890 NW RIVERVIEW AVE, GRESHAM, OR 97030-4918
(508) 202-6604
Mailing address
890 NW RIVERVIEW AVE, GRESHAM, OR 97030-4918
(508) 202-6604
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
202103094LPN
OR
Other
Enumeration date
04/30/2025
Last updated
04/30/2025
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