Individual
GUADALUPE VALERIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
324 NW DAVIS ST, PORTLAND, OR 97209-3925
(503) 502-0082
Mailing address
324 NW DAVIS ST, PORTLAND, OR 97209-3925
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
093005079LPN
OR
Other
Enumeration date
12/05/2018
Last updated
12/05/2018
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