Individual
MR. ROBERT DEACON PROUTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
722 NE 162ND AVE, PORTLAND, OR 97230-5760
(503) 408-5016
Mailing address
10590 NW LEE ST, PORTLAND, OR 97229-6249
(503) 475-4013
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
—
OR
Other
Enumeration date
04/22/2007
Last updated
07/08/2007
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