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Individual

CLIFTON A. J. EDWARDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MHA,REEGT,PMP, CPHQ

Contact information

Practice address
3347 NE 164TH LOOP, PORTLAND, OR 97230-5063
(971) 227-9340
Mailing address
3439 NE SANDY BLVD # 367, PORTLAND, OR 97232-1959
(971) 227-9340
(864) 364-5280

Taxonomy

Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
#3726: RPSGT
246Z00000X
Other Specialist/Technologist
#847: R. EP T.
246ZE0500X
EEG Specialist/Technologist
Primary
#3283: R. EEG T.
246ZE0600X
Electroneurodiagnostic Specialist/Technologist

Other

Enumeration date
11/21/2015
Last updated
02/28/2017
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