Individual
MS. CRYSTAL CHANTE VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12045 SE STANLEY AVE, MILWAUKIE, OR 97222-2938
(503) 659-2323
Mailing address
12045 SE STANLEY AVE, MILWAUKIE, OR 97222-2938
(503) 659-2323
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10002052
OR
Other
Enumeration date
08/15/2023
Last updated
08/17/2023
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