Individual
MS. LAURA BETHANY POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, MAIL CODE SJH-2, PORTLAND, OR 97239-3011
(503) 494-4910
(503) 494-8368
Mailing address
3181 SW SAM JACKSON PARK RD, MAIL CODE SJH-2, PORTLAND, OR 97239-3011
(503) 494-4910
(503) 494-8368
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
201406086NP
OR
363LC0200X
Critical Care Medicine Nurse Practitioner
232481
NC
363LC0200X
Critical Care Medicine Nurse Practitioner
5006497
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP2550
—
SC
Enumeration date
09/23/2013
Last updated
05/06/2019
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