Individual
CHERYL ANN DUVALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, LMT
Contact information
Practice address
19365 SW 65TH AVE, SUITE 104, TUALATIN, OR 97062-9196
(503) 699-7674
(503) 699-7759
Mailing address
19365 SW 65TH AVE, SUITE 104, TUALATIN, OR 97062-9196
(503) 699-7674
(503) 699-7759
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
3858
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
089006398RN
RN LICENSE
—
01
—
280922
RN LICENSE
CA
01
—
3858
LMT LICENSE
OR
Enumeration date
02/23/2010
Last updated
02/23/2010
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