Individual
AMY MARIE YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
2150 NE DIVISION ST, STE 103, GRESHAM, OR 97030-5813
(503) 661-4200
(503) 666-0566
Mailing address
2150 NE DIVISION ST, STE 103, GRESHAM, OR 97030-5813
(503) 661-4200
(503) 666-0566
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
087000193N2
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000480
—
OR
Enumeration date
05/22/2007
Last updated
07/09/2007
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