| NPI | 1316199987 |
|---|---|
| Doing Business As | PROV NURSE PRACTITIONERS EAST |
| Entity Type | Organization |
| Authorized Contact | WILLIAM OLSON Administrator 503-215-7384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2011-10-11 |