Individual
JOHN ZURITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14619 SW TEAL BLVD, BEAVERTON, OR 97007
(541) 398-1164
Mailing address
15055 SW ROYALTY PKWY, APT G26, TIGARD, OR 97224-3915
(541) 398-1164
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
17757
OR
Other
Enumeration date
09/24/2013
Last updated
09/24/2013
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