Provider Demographics
NPI:1124651518
Name:NUNEZ, ROBIN (IBCLC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18205 SW BROAD OAK BLVD
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-4611
Mailing Address - Country:US
Mailing Address - Phone:503-960-0444
Mailing Address - Fax:
Practice Address - Street 1:18205 SW BROAD OAK BLVD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-4611
Practice Address - Country:US
Practice Address - Phone:503-960-0444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL-164398174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN