Individual
MRS. ELISABETH HAYDEN HOLT MAKLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHCNP, ANP
Contact information
Practice address
9555 SW BARNES RD, SUITE 100, PORTLAND, OR 97225-6663
(503) 292-3577
(503) 292-3947
Mailing address
7650 SW BEVELAND RD, SUITE 200, PORTLAND, OR 97223-8692
(503) 292-3577
(503) 292-3947
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
200550107NP
OR
363LA2200X
Adult Health Nurse Practitioner
AP30007105
WA
363LW0102X
Women's Health Nurse Practitioner
Primary
200550108NP
OR
363LW0102X
Women's Health Nurse Practitioner
AP30007105
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278822
—
OR
05
—
9656042
—
WA
01
—
R186769
MEDICARE PTAN
OR
Enumeration date
06/11/2006
Last updated
06/21/2016
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