Individual
KATHERINE SANDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
541 NE 20TH AVE STE 210, PORTLAND, OR 97232
(503) 233-6940
Mailing address
800 SW 13TH AVE, PORTLAND, OR 97205-1902
(503) 221-0161
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201250094NP
OR
363LF0000X
Family Nurse Practitioner
26NJ00353200
NJ
Other
Enumeration date
12/19/2011
Last updated
03/24/2021
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