Individual
MORTUMA J.T MURRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP, PNP-AC-PC
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 418-5150
(503) 418-5165
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 418-5150
(503) 418-5165
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
201808002RN
OR
363LA2100X
Acute Care Nurse Practitioner
Primary
202110719NP-PP
OR
363LP0200X
Pediatric Nurse Practitioner
202110719NP-PP
OR
Other
Enumeration date
06/11/2021
Last updated
10/14/2021
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