Individual
MR. JIMMIE DON ERWIN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNAII
Contact information
Practice address
5435 SW 192ND AVE, ALOHA, OR 97078-3030
(503) 709-8100
Mailing address
5435 SW 192ND AVE, ALOHA, OR 97078-3030
(503) 709-8100
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
201705353CNA
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121616
MODA
OR
Enumeration date
01/02/2022
Last updated
01/02/2022
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