Healthcare Provider Details

I. General information

NPI: 1992975262
Provider Name (Legal Business Name): WILLIAM DELPLATO RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2008
Last Update Date: 03/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1753 SW PHYLLIS AVE
GRESHAM OR
97080-8398
US

IV. Provider business mailing address

PO BOX 807
GRESHAM OR
97030-0187
US

V. Phone/Fax

Practice location:
  • Phone: 503-888-6683
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number89-006825
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: