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Individual

ANNA MALORA HARTSHORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ACNP

Contact information

Practice address
9701 SW BARNES RD, SUITE 300, PORTLAND, OR 97225-6772
(503) 297-8081
(503) 292-6601
Mailing address
975 SE SANDY BLVD, SUITE 201, PORTLAND, OR 97214-1308
(503) 236-0775
(503) 236-0786

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
200950124NP
OR
363LF0000X
Family Nurse Practitioner
APN11462
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1174724157
WA
05
500613719
OR
Enumeration date
05/29/2007
Last updated
10/02/2012
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