Individual
KAREN ANN BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
417 SW 117TH AVE, SUITE 100, PORTLAND, OR 97225-5924
(503) 216-1800
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201391813NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500664691
—
OR
01
—
P01328156
RR MEDICARE - PROVIDENCE
OR
Enumeration date
11/04/2013
Last updated
11/07/2014
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