PENNY JOHNSRUD

GRESHAM, OR
NPI1851317598
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner Family
(Licence: OR  095006656N1)
Additional Taxonomies363LF0000X Nurse Practitioner Family
(Licence: WA  AP30005364)
Enumeration Date2006-07-14
Last Update Date2011-11-11
Business Address
PENNY JOHNSRUD FNP
501 NE HOOD AVE SUITE 100
GRESHAM, OR 97030-7303
Phone number: 503-775-4931
Mailing Address
PENNY JOHNSRUD FNP
3727 NE MARTIN LUTHER KING JR BLVD ATTN: CREDENTIALING
PORTLAND, OR 97212-1112
Phone number: 503-775-4931