Individual
YOUNG SPARKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(503) 234-9591
(503) 205-3554
Mailing address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(503) 234-9591
(503) 205-3554
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201609878RN
OR
163W00000X
Registered Nurse
95109874
CA
Other
Enumeration date
02/03/2017
Last updated
02/03/2017
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