Individual
LYNN ELLIS EASTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8372
Mailing address
14210 SE 22ND CIR, VANCOUVER, WA 98683-8400
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
089006048N0
OR
363LA2100X
Acute Care Nurse Practitioner
089006048RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275314
—
OR
Enumeration date
07/31/2006
Last updated
07/08/2007
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