| NPI | 1639710783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WA AP61056892) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 201909923NP-PP) |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: OR 201901430RN) | |
| 207Q00000X Family Medicine (Licence: OR F09190719) | |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2022-02-14 |