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Individual

DIANE BINGHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
12360 E BURNSIDE ST, PORTLAND, OR 97233-1042
(971) 279-4800
(971) 279-2051
Mailing address
210 NE 92ND PL, PORTLAND, OR 97220-4521
(503) 252-5555

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
099007797RN
OR
163W00000X
Registered Nurse
211238-3102
UT
163W00000X
Registered Nurse
45076
OK
163W00000X
Registered Nurse
60065138RN
WA
163W00000X
Registered Nurse
RN27019
NV
163W00000X
Registered Nurse
T-551095
NV

Other

Enumeration date
07/07/2016
Last updated
01/09/2019
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