Individual
DIANE INDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
847 NE 19TH AVE STE 100, PORTLAND, OR 97232-2684
(503) 238-0769
Mailing address
PO BOX 3417, PORTLAND, OR 97208-3417
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
18234
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
200394
SD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
2015005058
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201801068NP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
3771798
ID
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
408420
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
70107462
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
898866
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500742223
—
OR
Enumeration date
09/23/2015
Last updated
05/11/2026
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