Individual
LUCY RIDEOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4816 NW BETHANY BLVD, PORTLAND, OR 97229-9254
(888) 227-3312
(971) 282-0100
Mailing address
PO BOX 2928, PORTLAND, OR 97208-2928
(425) 207-5155
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201605242RN
OR
363LF0000X
Family Nurse Practitioner
Primary
10007710
OR
Other
Enumeration date
03/06/2017
Last updated
07/15/2024
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