Individual
ERIN K MYKLEBUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
9135 SW BARNES RD, STE 261, PORTLAND, OR 97225-6601
(503) 216-6300
(503) 216-6324
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
092007010N3
OR
363LA2200X
Adult Health Nurse Practitioner
Primary
092007010N3
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
236475
—
OR
Enumeration date
05/27/2005
Last updated
03/22/2021
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