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1356044200
BRIAN DOUGLAS ROTH
PORTLAND, OR
NPI
1356044200
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: OR 200841450RN)
Enumeration Date
2023-03-22
Last Update Date
2023-03-22
Business Address
BRIAN DOUGLAS ROTH
13317 SE POWELL BLVD
PORTLAND, OR 97236-3335
Phone number: 503-763-9606
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Mailing Address
BRIAN DOUGLAS ROTH
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number:
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