Individual
MAUREEN M UPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3550 N INTERSTATE AVE, EAST INTERSTATE MEDICAL OFFICE, PORTLAND, OR 97227
(503) 528-2461
Mailing address
6959 N FENWICK AVE, PORTLAND, OR 97217-5305
(971) 998-2201
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
200642131RN
OR
163W00000X
Registered Nurse
614930
CA
163WG0000X
General Practice Registered Nurse
FN00168990
WA
363LF0000X
Family Nurse Practitioner
15528
CA
363LF0000X
Family Nurse Practitioner
Primary
200650101FNP-PP
OR
363LF0000X
Family Nurse Practitioner
AP30007614
WA
Other
Enumeration date
09/14/2006
Last updated
12/29/2021
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