Matthew David Fontaine, AAS Valid NPI

Individual provider · Psychiatric/Mental Health Registered Nurse · Portland, OR

NPI

1144515289

Type

Individual (Type 1)

Primary specialty

Psychiatric/Mental Health Registered Nurse (Registered Nurse)

Specialty group

Nursing Service Providers

Taxonomy code

163WP0808X

License number

201140738RN (OR)

Sex

Male

Sole proprietor

No

Enumerated

2011-06-16

Last updated

2011-06-16