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General NPI Number Information
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NPI Number | 1598591356
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Entity Type | Individual
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Provider Name | RODRIGO GUZMAN
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Gender | Male
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Dates
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Enumeration Date | 09/10/2024
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 2655 SE 50TH AVE APT 117
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City | PORTLAND
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State | OR
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Zip | 97206-1577
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Country | US
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Telephone | 541-371-0853
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Fax |
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Provider Business Mailing Address
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Address Line | 78800 DOWNEY RD
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City | BOARDMAN
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State | OR
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Zip | 97818-9696
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Country | US
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Telephone | 541-371-0853
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 10003240
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License Number State | OR
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