Individual
ELIZABETH H FEDDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1024 SW 12TH ST, TROUTDALE, OR 97060-1498
(503) 813-2000
Mailing address
1024 SW 12TH ST, TROUTDALE, OR 97060-1498
(503) 209-3868
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201604219NP-PP
OR
363LF0000X
Family Nurse Practitioner
AP60653190
WA
Other
Enumeration date
08/24/2015
Last updated
11/17/2016
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