Individual
CALLIE M SOCKLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
9135 SW BARNES RD STE 261, PORTLAND, OR 97225-6784
(503) 215-2300
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
201706710NP-PP
OR
363LG0600X
Gerontology Nurse Practitioner
201706710NP-PP
OR
390200000X
Student in an Organized Health Care Education/Training Program
201504243RN
OR
Other
Enumeration date
08/28/2016
Last updated
04/25/2023
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