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Individual

MS. CHARLENE AFABLE MAXWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
600 NE 8TH ST, #300, GRESHAM, OR 97030-7317
(503) 988-5155
(509) 988-5185
Mailing address
421 SW OAK ST, STE. 210, PORTLAND, OR 97204-1817
(503) 988-7468
(503) 988-3015

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201391238NP-PP
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
096511
OR
05
22959
OR
Enumeration date
02/20/2013
Last updated
08/11/2014
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