Individual
DEBORAH SUE DORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, ANP
Contact information
Practice address
1111 NE 99TH AVE, SUITE 201, PORTLAND, OR 97220-9442
(503) 962-1000
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
07943285N3
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
083217
—
OR
Enumeration date
08/11/2005
Last updated
01/10/2013
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