Individual
ELISABETH ROMATZ MAHMUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, AGNP
Contact information
Practice address
3680 NW SAMARITAN DR, CORVALLIS, OR 97330-3737
(541) 754-1150
Mailing address
444 NW ELKS DRIVE, CORVALLIS, OR 97330
(541) 754-1150
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
NC60406565
WA
363LG0600X
Gerontology Nurse Practitioner
Primary
201701726NP-PP
OR
363LG0600X
Gerontology Nurse Practitioner
AP60689189
WA
Other
Enumeration date
09/27/2016
Last updated
07/21/2022
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