Individual
DUSTIN RHOADES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
THW
Contact information
Practice address
1825 NE GLISAN ST, PORTLAND, OR 97232-2844
(503) 963-7652
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
THW000105185
OR
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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