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1780236406
MARVIN BRADLEY LILLY
PORTLAND, OR
NPI
1780236406
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: OR 201391789RN)
Enumeration Date
2019-07-12
Last Update Date
2019-07-12
Business Address
MARVIN BRADLEY LILLY
1535 N WILLIAMS AVE
PORTLAND, OR 97227-1885
Phone number: 503-238-2067
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Mailing Address
MARVIN BRADLEY LILLY
232 NW 6TH AVE
PORTLAND, OR 97209-3609
Phone number: 503-294-1681
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