Provider Demographics
NPI:1568953040
Name:ONNIS, DORIS ANN (RN, BSN, IBCLC)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:ANN
Last Name:ONNIS
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9155 SW BARNES RD STE 730
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6634
Mailing Address - Country:US
Mailing Address - Phone:503-216-4096
Mailing Address - Fax:
Practice Address - Street 1:9155 SW BARNES RD STE 730
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6634
Practice Address - Country:US
Practice Address - Phone:503-216-4096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL-30272163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant