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1124627054
MUSAH N IDDRISU
PORTLAND, OR
NPI
1124627054
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: OR 10017169)
Enumeration Date
2020-10-21
Last Update Date
2023-11-07
Business Address
MUSAH N IDDRISU RN
12710 SE DIVISION ST
PORTLAND, OR 97236-3134
Phone number: 503-988-3601
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Mailing Address
MUSAH N IDDRISU RN
619 NW 6TH AVE FL 5
PORTLAND, OR 97209-3964
Phone number: 503-988-7468
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