Individual
KELLY SCHOEPPNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
420 NE MASON ST, PORTLAND, OR 97211-3479
(503) 546-9292
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
163WH1000X
Hospice Registered Nurse
AP30004389
WA
163WH1000X
Hospice Registered Nurse
RN00128492
WA
363L00000X
Nurse Practitioner
Primary
201392002NP-PP
OR
363L00000X
Nurse Practitioner
AP30004389
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0209727
STATE L&I
WA
01
—
8941623
STATE CRIME VICTIMS
WA
05
—
9626268
—
WA
Enumeration date
07/14/2006
Last updated
09/18/2020
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