Individual
KATHLEEN POLITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(540) 451-1032
Mailing address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 220-8262
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
201501124RN
OR
363L00000X
Nurse Practitioner
Primary
202111916NP-PP
OR
Other
Enumeration date
06/08/2019
Last updated
10/27/2021
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