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Individual

ANDREA LOUISELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
4015 MERCANTILE DR STE 200, SUITE 200, LAKE OSWEGO, OR 97035-2552
(503) 216-1538
Mailing address
5406 SW FLORIDA ST, PORTLAND, OR 97219-1300
(503) 476-7727

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
200242256
OR
363LF0000X
Family Nurse Practitioner
Primary
201507030NP-PP
OR

Other

Enumeration date
08/14/2015
Last updated
03/17/2018
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