Individual
MARTHA DRIESSNACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3455 SW US VETERANS HOSPITAL RD, SN-6S, PORTLAND, OR 97239-3076
(503) 418-1271
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 418-5700
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
201350041NP
OR
Other
Enumeration date
07/23/2014
Last updated
07/23/2014
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