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NPI Code Detail

MEDICARE: MISS KATIA RENEE RUIZ HOPPER FNP-C

MEDICARE: MISS KATIA RENEE RUIZ HOPPER FNP-C
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
1207Q00000XFamily Medicine PhysicianAP61076984WA
2207Q00000XFamily Medicine Physician202006424NP-PPOR

General Provider Information

NPI Number : 1598367211
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS KATIA RENEE RUIZ HOPPER FNP-C
Provider Business Mailing Address
First Line : 7477 SE 52ND AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97206-8206
Country : US
Telephone Number : 206-379-0879
Fax Number :
Provider Business Practice Location Address
First Line : 7477 SE 52ND AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97206-8206
Country : US
Telephone Number : 206-379-0879
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2020
Last Update Date : 11/09/2020

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Directions to “ MISS KATIA RENEE RUIZ HOPPER FNP-C” Practice Location

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