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Individual

MR. COLIN ANGUS MCINNES JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PMHNP

Contact information

Practice address
3601 W 10TH ST, THE DALLES, OR 97058-4377
(503) 234-9591
Mailing address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(503) 234-9591

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
200241682RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
200850088NP FNP-PP
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
218112
OR
Enumeration date
09/17/2008
Last updated
09/15/2022
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