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1932749173
TREVA SAKURA DRAKE
PORTLAND, OR
NPI
1932749173
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Former Name
TREVA JACKSON
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: OR 201909401RN)
Enumeration Date
2020-01-15
Last Update Date
2020-01-15
Business Address
TREVA SAKURA DRAKE
1111 NW NAITO PKWY
PORTLAND, OR 97209-2596
Phone number: 503-488-7720
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Mailing Address
TREVA SAKURA DRAKE
232 NW 6TH AVE
PORTLAND, OR 97209-3609
Phone number: 503-294-1681
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