Individual
NALLELY VILLEGAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4310 NE KILLINGSWORTH ST, PORTLAND, OR 97218-1404
(503) 535-1151
Mailing address
4310 NE KILLINGSWORTH ST, PORTLAND, OR 97218-1404
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
02/02/2017
Last updated
02/02/2017
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