Provider Demographics
NPI:1962642470
Name:CRUZ, D'LEAH (RN)
Entity Type:Individual
Prefix:MRS
First Name:D'LEAH
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8844 SW ROMAL CT
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-7290
Mailing Address - Country:US
Mailing Address - Phone:503-780-5508
Mailing Address - Fax:503-641-8003
Practice Address - Street 1:10180 SE SUNNYSIDE RD
Practice Address - Street 2:SUITE B, 1ST FLOOR
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-8970
Practice Address - Country:US
Practice Address - Phone:503-571-0905
Practice Address - Fax:503-517-0867
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-23
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR096006061RN163W00000X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult