Erica Marie Divine, LPN

NPI #1144633140 in Beaverton, Oregon

Provider Information

NPI Number
1144633140
Entity Type
Individual
Name
Erica Marie Divine, LPN
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Licensed Practical Nurse
Credential
LPN
Enumeration Date
Jun 6, 2014
Last Updated
Jun 6, 2014

Practice Location

Address
14095 SW WALKER RD APT 144
State
Oregon
ZIP Code
97005-1075
Phone
(503) 415-1741

Specialties & Taxonomy Codes

Specialty
Licensed Practical Nurse

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