Individual
MAFE VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97207-1034
(503) 220-8262
Mailing address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97207-1034
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
200930479LPN
OR
Other
Enumeration date
01/08/2010
Last updated
06/24/2022
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