IndividualActive
Dominique Mann, AGACNP- BC
NPI 1942998612 · Gerontology Nurse Practitioner · Portland, OR
Provider details
- NPI number
- 1942998612
- Entity type
- Individual
- Primary specialty
- Gerontology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- AGACNP- BC
- Sex
- Female
- Sole proprietor
- No
- License
- 10004407 (OR)
Practice location
4400 Ne Halsey St Ste 102
Portland, OR 97213-1545
Phone: (503) 962-1000
Mailing address
Po Box 3158
Portland, OR 97208-3158
Registry dates
- Enumerated
- 2023-05-01
- Last updated
- 2024-02-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.