Individual
DESTINY ROBIN THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2544 NE CLACKAMAS ST, PORTLAND, OR 97232-1727
(503) 975-3257
Mailing address
558 S DONNA DR, NEWBERG, OR 97132-2277
(503) 899-5987
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
NONE
OR
Other
Enumeration date
04/26/2020
Last updated
04/26/2020
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