MEDICARE: ROBIN FIRTH RN BSN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	094003274RN	OR

General Provider Information

NPI Number	:	1073314373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN FIRTH RN BSN

Provider Business Mailing Address
First Line	:	4702 SW DOSCH PARK LN
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97239-1284
Country	:	US
Telephone Number	:	503-209-4562
Fax Number	:

Provider Business Practice Location Address
First Line	:	10149 SW BARBUR BLVD STE B
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97219-5918
Country	:	US
Telephone Number	:	503-209-4562
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2025
Last Update Date	:	03/22/2025

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