Individual
SANDRA ANN BANTA WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
707 SW GAINES ST, PORTLAND, OR 97239-2901
(800) 452-3563
Mailing address
7316 SE 13TH AVE, PORTLAND, OR 97202-5922
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
O84059397RN
OR
363LN0000X
Neonatal Nurse Practitioner
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000552
—
OR
Enumeration date
10/09/2006
Last updated
07/08/2007
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