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General NPI Number Information
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NPI Number | 1194000265
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Entity Type | Individual
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Provider Name | JANELLE BANDURRAGA-RICE LDM
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Gender | Female
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Dates
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Enumeration Date | 10/19/2011
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 1608 SE ANKENY ST
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City | PORTLAND
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State | OR
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Zip | 97214-1448
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Country | US
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Telephone | 503-233-3001
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Fax |
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Provider Business Mailing Address
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Address Line | 19705 SW BOONES FERRY RD APT 56
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City | TUALATIN
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State | OR
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Zip | 97062-9441
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Country | US
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Telephone | 360-820-3010
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | DEM-LD-10198390
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License Number State | OR
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