Individual
DR. COLLEEN MARIE CASEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, ANP, CNS
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, DIVISION OF INTERNAL MEDICINE, L475, PORTLAND, OR 97239-3011
(503) 494-8562
Mailing address
3181 SW SAM JACKSON PARK RD, DIVISION OF INTERNAL MEDICINE, L475, PORTLAND, OR 97239-3011
(503) 494-8562
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201050070NP
OR
364S00000X
Clinical Nurse Specialist
200770014CNS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ANP736
STATE OF OREGON WORKERS' COMPENSATION NUMBER
OR
Enumeration date
06/17/2010
Last updated
12/03/2010
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