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General NPI Number Information
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NPI Number | 1356574412
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Entity Type | Organization
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Legal Business Name | MULTIPLE SCLEROSIS SOCIETY OF PORTLAND OREGON, INC
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Dates
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Enumeration Date | 08/24/2009
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Last Update Date | 09/17/2012
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Provider Practice Location Address
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Address Line | 2901 SE 122ND AVE
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City | PORTLAND
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State | OR
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Zip | 97236-3205
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Country | US
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Telephone | 503-297-9544
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Fax | 503-297-6264
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Provider Business Mailing Address
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Address Line | 2901 SE 122ND AVE
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City | PORTLAND
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State | OR
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Zip | 97236-3205
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Country | US
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Telephone | 503-297-9544
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Fax | 503-297-6264
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. CANDYCE L HAYES
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Credential |
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Telephone | 503-297-9544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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