Individual
ANGELA M LIBERATORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-5856
(503) 494-2370
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-5856
(503) 494-2370
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
202111928NP-PP
OR
363LP0200X
Pediatric Nurse Practitioner
F380664
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02743204
—
NY
Enumeration date
08/03/2006
Last updated
03/11/2022
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