Individual
MS. IRENE MARY WILLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
334 REUTER LN, FOREST GROVE, OR 97116-1200
(503) 357-1602
Mailing address
334 REUTER LN, FOREST GROVE, OR 97116-1200
(503) 357-1602
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28599
OR
Other
Enumeration date
02/09/2010
Last updated
02/09/2010
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