Individual
DARYA BALANETSKAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACPCNP
Contact information
Practice address
17727 E BURNSIDE ST, PORTLAND, OR 97233-4803
(503) 215-9800
Mailing address
17727 E BURNSIDE ST, PORTLAND, OR 97233-4803
(503) 215-9800
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201504283RN
OR
363L00000X
Nurse Practitioner
202206690NP-PP
OR
363LG0600X
Gerontology Nurse Practitioner
Primary
202206690NP-PP
OR
363LP2300X
Primary Care Nurse Practitioner
202206690NP-PP
OR
Other
Enumeration date
01/08/2022
Last updated
10/25/2024
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