Individual
MR. SAMUEL JOSEPH CROSS-SARVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC, FNP-C
Contact information
Practice address
5263 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97211-3235
(503) 217-4455
Mailing address
5263 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97211-3235
(503) 217-4455
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00176573
WA
363LF0000X
Family Nurse Practitioner
95003416
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201707205NP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
60621382
WA
Other
Enumeration date
02/25/2011
Last updated
07/19/2021
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