Provider Demographics
NPI:1073149928
Name:DE VOIR, ANN
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:DE VOIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 SW GREENWAY AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-1452
Mailing Address - Country:US
Mailing Address - Phone:503-502-3588
Mailing Address - Fax:503-521-0908
Practice Address - Street 1:2905 SW GREENWAY AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97201-1452
Practice Address - Country:US
Practice Address - Phone:503-502-3588
Practice Address - Fax:503-521-0908
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-22
Last Update Date:2020-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR084054443RN163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health