Dan Black

NPI 1619150620 - Student in an Organized Health Care Education/Training Program - 390200000X

NPI Details
NPI 1619150620
Gender Male
Enumeration Date 12/12/2007
Last Updated 12/12/2007
Entity Type Individual
Active Over 8 years ago
Practice Location
1500 NE IRVING ST
250
PORTLAND OR, 97232-2243, US
Phone (503) 233-4356
Fax
Business Location
1108 JEFFERSON ST
OREGON CITY OR, 97045-1673, US
Phone
Fax
Toxanomy
Taxonomy Code 390200000X
License State
License Number
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According to our database, Dan Black NPI is 1619150620, taxonomy code is 390200000X Dan Black physically located at 1500 Ne Irving St, Portland OR, 97232-2243. NPI Number Dan Black has the Individual type.

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1619150620 NPI number is provided on an as is basis without warranty of any kind. 1619150620 is maintained by the National Plan & Provider Enumeration System. The contents of Dan Black are for informational purposes only.