Provider Demographics
NPI:1396216545
Name:TORRES, MANUEL (RN)
Entity Type:Individual
Prefix:
First Name:MANUEL
Middle Name:
Last Name:TORRES
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7102 SE HARNEY ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-8724
Mailing Address - Country:US
Mailing Address - Phone:503-888-4818
Mailing Address - Fax:
Practice Address - Street 1:502 E BOONE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99258-3200
Practice Address - Country:US
Practice Address - Phone:800-322-2584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2023-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60966139390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program