Individual
BRUCE ALAN MARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
3930 SE DIVISION ST, PORTLAND, OR 97202-1643
(503) 418-3900
Mailing address
3930 SE DIVISION ST, PORTLAND, OR 97202-1643
(503) 418-3900
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
200141561RN
OR
363LF0000X
Family Nurse Practitioner
Primary
200350074NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029011
—
OR
Enumeration date
08/01/2006
Last updated
07/13/2010
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