Individual
COLLEEN DUNCAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
223 E POWELL BLVD, GRESHAM, OR 97030-7605
(503) 667-1500
Mailing address
1142 SE ROBERTS AVE, GRESHAM, OR 97080-7844
(971) 506-7587
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
17665
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17665
LICENSE NUMBER
—
Enumeration date
03/14/2014
Last updated
03/14/2014
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