Individual
JAMES PASSALACQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1470 NW 4TH ST, REDMOND, OR 97756-1366
(541) 516-4099
Mailing address
1470 NW 4TH ST, REDMOND, OR 97756-1366
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
10031944
OR
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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