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1629565981
KUFA DEKAMO
PORTLAND, OR
NPI
1629565981
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: OR 201802274LPN)
Enumeration Date
2018-04-21
Last Update Date
2018-04-21
Business Address
KUFA DEKAMO
3708 SE 144TH AVE
PORTLAND, OR 97236-2731
Phone number: 571-315-7771
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Mailing Address
KUFA DEKAMO
3708 SE 144TH AVE
PORTLAND, OR 97236-2731
Phone number: 571-315-7771
Copy
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