Individual
ANNETTE N SAMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9605 GRAND RONDE RD, GRAND RONDE, OR 97347-9712
(503) 879-2002
(503) 879-2071
Mailing address
9615 GRAND RONDE RD, GRAND RONDE, OR 97347-9712
(503) 879-2002
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201141804RN
OR
363LF0000X
Family Nurse Practitioner
Primary
202214454NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171037
—
OR
Enumeration date
07/27/2010
Last updated
07/25/2024
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