Doctor Name: | GREGORY RUSSELL POLLARD-HERMANN |
NPI Number: | 1932251048 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | RN |
License Number: | 201043543RN |
Business Practice Address: | 10180 Se Sunnyside Rd Clackamas, OR - 970158970 |
Business Phone Number: | 5036522880 |
Business Fax Number: | |
Mailing Address: | 3601 Sw River Pkwy, Suite 1014 PORTLAND |
State: | OR |
Postal Code: | 972394553 |
Phone Number: | 6199204077 |
Fax Number: | |
NPI Enumeration Date: | 01/17/2007 |
NPI Last Update Date: | 03/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 201043543RN |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |