Individual
AMY STIVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1153 MOLALLA AVE, OREGON CITY, OR 97045
(503) 515-4004
(503) 446-3398
Mailing address
2125 SE MAIN ST, PORTLAND, OR 97214-3839
(503) 515-4004
(503) 446-3398
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN169713
GA
363LG0600X
Gerontology Nurse Practitioner
Primary
201506048NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500692367
—
OR
Enumeration date
03/01/2014
Last updated
10/28/2019
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