Individual
MRS. ROBERTA JEAN HURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2600 SE BELMONT ST, PORTLAND, OR 97214-2916
(503) 843-8823
Mailing address
4925 SW 45TH AVE APT 15, PORTLAND, OR 97221-3663
(503) 317-5317
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
200170096LPN
OR
Other
Enumeration date
12/19/2017
Last updated
12/19/2017
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