Individual
MAURICE BOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6601 NE 78TH CT, SUITE A3, PORTLAND, OR 97218-2823
(503) 252-3949
Mailing address
6601 NE 78TH CT, SUITE A3, PORTLAND, OR 97218-2823
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201130606LPN
OR
Other
Enumeration date
03/29/2017
Last updated
03/29/2017
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