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NPI Code Detail

MEDICARE: SHARON D BUTCHER PNP

MEDICARE: SHARON D BUTCHER PNP
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
1363LP0200XPediatric Nurse Practitioner095006346N2OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568437960
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARON D BUTCHER PNP
Provider Business Mailing Address
First Line : 11870 SE AUSTRAILIS CT
Second Line :
City : CLACKAMAS
State : OR
Zip : 97015-9608
Country : US
Telephone Number : 503-698-7503
Fax Number :
Provider Business Practice Location Address
First Line : 2801 N GANTENBEIN AVE
Second Line : STE 2225
City : PORTLAND
State : OR
Zip : 97227-1623
Country : US
Telephone Number : 503-413-4505
Fax Number : 503-413-4719
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2006
Last Update Date : 07/08/2007

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