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Organization
PORTLAND VA MEDICAL CENTER
Active
Organization
PORTLAND VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYNETTE KAPUALANI WATTS GNP (GERIATRIC NURSE PRACTITIONER)
(503) 237-0153
Entity
Organization
Contact information
Practice address
1601 E FOURTH PLAIN BLVD, VANCOUVER, WA 98661-3753
(503) 220-8262
Mailing address
21950 S UPPER HIGHLAND RD, BEAVERCREEK, OR 97004-8810
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
060018996N3ANP/GNP
OR
Other
Enumeration date
09/25/2006
Last updated
08/14/2008
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