Individual
MRS. DANA JONES ULRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
19250 SW 65TH AVE, SUITE 300, TUALATIN, OR 97062-7452
(503) 692-1242
(503) 691-3615
Mailing address
7650 SW BEVELAND RD, SUITE 200, PORTLAND, OR 97223-8692
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
201505551NP-PP
OR
367A00000X
Advanced Practice Midwife
Primary
201505551NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500691830
—
OR
01
—
R184165
MEDICARE PTAN
OR
Enumeration date
08/13/2015
Last updated
07/05/2016
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