Individual
NGA VU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
9775 SE SUNNYSIDE RD, SUITE 200, CLACKAMAS, OR 97015-5739
(503) 654-8417
(503) 654-8218
Mailing address
2428 NE 20TH AVE, PORTLAND, OR 97212-4640
(503) 807-6657
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
093000591N1
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126370
—
OR
Enumeration date
10/25/2005
Last updated
01/20/2016
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