NPI 1235538000

Marcelo Agustin

Practitioner Nurse's Aide Portland, OR

Practice location

Address: 3415 SE Powell Blvd, Portland, OR 97202-3371
Phone: (503) 234-9591

Registered specialties

Nurse's Aide Primary

Nursing Service Related Providers Taxonomy 376K00000X Licence 201220087CMA (OR)

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Registry record

NPI: 1235538000
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Aug 2014
Record last updated: 18 Aug 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.