Provider Demographics
NPI:1750055380
Name:MUNOZ ROMERO, ANA COLOMBIA
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:COLOMBIA
Last Name:MUNOZ ROMERO
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 1:2633 SE 145TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97236-2663
Mailing Address - Country:US
Mailing Address - Phone:949-412-2786
Mailing Address - Fax:
Practice Address - Street 1:3639 SE 12TH ST
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97080-9132
Practice Address - Country:US
Practice Address - Phone:971-276-2213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201709322RN163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency