Individual
GENEVA RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
13043 SE 84TH AVE, CLACKAMAS, OR 97015-9798
(971) 930-5582
Mailing address
PO BOX 2392, ESTACADA, OR 97023-2392
(503) 830-1622
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10008926
OR
363L00000X
Nurse Practitioner
AP61432615
WA
Other
Enumeration date
05/02/2023
Last updated
06/06/2023
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