Provider Demographics
NPI:1922860576
Name:VELASQUEZ, RIANNA CHRISTINE II
Entity Type:Individual
Prefix:
First Name:RIANNA
Middle Name:CHRISTINE
Last Name:VELASQUEZ
Suffix:II
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 1:18361 NE MULTNOMAH ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-7142
Mailing Address - Country:US
Mailing Address - Phone:503-351-3839
Mailing Address - Fax:
Practice Address - Street 1:18361 NE MULTNOMAH ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-7142
Practice Address - Country:US
Practice Address - Phone:503-351-3839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist