Individual
ANZHELIKA GAVRILOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4540 NE GLISAN ST, PORTLAND, OR 97213-2333
(503) 215-3738
Mailing address
4540 NE GLISAN ST, PORTLAND, OR 97213-2333
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
Primary
200941904RN
OR
Other
Enumeration date
11/23/2016
Last updated
11/23/2016
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