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1922427657
ILENE HIBBERT
TUALATIN, OR
NPI
1922427657
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
302R00000X Health Maintenance Organization
(Licence: OR 093003236RN)
Enumeration Date
2014-04-09
Last Update Date
2014-04-09
Business Address
ILENE HIBBERT
7668 SW MOHAWK ST
TUALATIN, OR 97062-8119
Phone number: 503-885-5110
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Mailing Address
ILENE HIBBERT
7668 SW MOHAWK ST
TUALATIN, OR 97062-8119
Phone number: 503-885-5110
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