Individual
PEGGY LYNN HUMPHRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10700 SW BEAVERTON HILLSDALE HWY BLDG 1, BEAVERTON, OR 97005-3019
(503) 645-9010
Mailing address
5042 S CORBETT AVE APT 7, PORTLAND, OR 97239-3944
(925) 812-4201
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
19-CRM-138
OR
Other
Enumeration date
07/24/2020
Last updated
07/24/2020
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