Individual
GWEN SAMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6800 SW 105TH AVE STE 206, BEAVERTON, OR 97008-5487
(503) 430-1777
(503) 372-5119
Mailing address
6800 SW 105TH AVE STE 206, BEAVERTON, OR 97008-5487
(503) 430-1777
(503) 372-5119
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
26NJ00678600
NJ
363LG0600X
Gerontology Nurse Practitioner
Primary
201703018NP-PP
OR
363LG0600X
Gerontology Nurse Practitioner
26NJ00678600
NJ
Other
Enumeration date
10/21/2016
Last updated
04/06/2023
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