Individual
STEFANIE B AVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1015 NW 22ND AVE, PORTLAND, OR 97210-3025
(503) 413-3900
(503) 413-3710
Mailing address
PO BOX 4037, PORTLAND, OR 97208-4037
(503) 413-3900
(503) 413-3710
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP61113937
WA
363LF0000X
Family Nurse Practitioner
Primary
201250137NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2022827
—
WA
Enumeration date
09/13/2012
Last updated
12/28/2020
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