Individual
DENISE JANETOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
725 S WAHANNA RD, SEASIDE, OR 97138-7735
(503) 717-7000
Mailing address
PO BOX 3397, PORTLAND, OR 97208-3397
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201250055NP
OR
363LF0000X
Family Nurse Practitioner
AP30004072
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00425052
RAILROAD MEDICARE
—
Enumeration date
06/18/2006
Last updated
03/18/2021
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