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1588448617
MICHAEL MIMS
PORTLAND, OR
NPI
1588448617
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163WE0003X Registered Nurse, Emergency
(Licence: MS 887609)
Enumeration Date
2023-08-21
Last Update Date
2023-08-21
Business Address
MICHAEL MIMS
3710 SW US VETERANS HOSPITAL RD
PORTLAND, OR 97239-2964
Phone number: 360-759-1901
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Mailing Address
MICHAEL MIMS
7466 GRANT VILLAGE DR APT C
SAINT LOUIS, MO 63123-1431
Phone number: 662-582-0579
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