Individual
CHRISTINA DODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP, PMHNP
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 220-8262
Mailing address
2020 SW 71ST AVE, PORTLAND, OR 97225-3706
(503) 297-2326
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
091000125N6
OR
Other
Enumeration date
08/08/2006
Last updated
07/08/2007
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