Organization
OREGON PSYCH NP, LLC
Active
Parent organization
OREGON PSYCH NP, LLC
Other names
Oregon Psych NP, LLC, Kimberly Sue Butler
Organization subpart
Yes
Provider details
NPI number
Legal business name
OREGON PSYCH NP, LLC
Authorized official
KIMBERLY SUE BUTLER PMHNP (MANAGING MEMBER)
(541) 382-1395
Entity
Organization
Contact information
Practice address
1569 SW NANCY WAY STE 2, BEND, OR 97702-3234
(541) 382-1395
(541) 382-6576
Mailing address
PO BOX 5264, BEND, OR 97708-5264
(503) 853-9356
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578934535
NPI
—
Enumeration date
10/13/2021
Last updated
02/19/2025
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