Provider Demographics
NPI:1154015261
Name:DTOLEDO, HECTOR (RN)
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:DTOLEDO
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 1:3033 SE PERSONS CT
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97267-4659
Mailing Address - Country:US
Mailing Address - Phone:503-657-1400
Mailing Address - Fax:503-662-2908
Practice Address - Street 1:3033 SE PERSONS CT
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97267-4659
Practice Address - Country:US
Practice Address - Phone:503-657-1400
Practice Address - Fax:503-662-2908
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR91003324RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse