Provider Demographics
NPI:1346896636
Name:MCAVOY, JAMES ARTHUR III (RN)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ARTHUR
Last Name:MCAVOY
Suffix:III
Gender:M
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:2121 SE BELMONT ST APT 419
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-3478
Mailing Address - Country:US
Mailing Address - Phone:206-359-2526
Mailing Address - Fax:503-215-9810
Practice Address - Street 1:17727 E BURNSIDE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233-4803
Practice Address - Country:US
Practice Address - Phone:503-215-9800
Practice Address - Fax:503-215-9810
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201906009RN163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management