Individual
DOMINIQUE FRANCESCA MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP- BC
Contact information
Practice address
4400 NE HALSEY ST STE 102, PORTLAND, OR 97213-1545
(503) 962-1000
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
10004407
OR
363LA2100X
Acute Care Nurse Practitioner
95021689
CA
363LG0600X
Gerontology Nurse Practitioner
Primary
10004407
OR
Other
Enumeration date
05/01/2023
Last updated
02/02/2024
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