Most Relevant Information
Provider Data
| NPI Number: | 1003030057 |
| Provider Name: | MICHAEL R COON LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/12/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
808 SW ALDER ST
SUITE 300
PORTLAND
OR
972053133
Practice Location Phone/Fax
| Phone: | 5032262203 |
| Fax: | 5032234231 |
Provider Mailing Location
252 NE KANE DR
APT 19
GRESHAM
OR
970301515
Provider Mailing Phone/Fax
| Phone: | 9712235777 |
| Fax: |