Individual
JESSICA ERIN MACALUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
16671 NW DUBLIN CT, PORTLAND, OR 97229-1895
(503) 746-7404
Mailing address
16671 NW DUBLIN CT, PORTLAND, OR 97229-1895
(503) 746-7404
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
200930404LPN
OR
Other
Enumeration date
09/21/2009
Last updated
09/21/2009
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