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NPI Code Detail

MEDICARE: MRS. JOANNA BETH URETSKY N.P.

MEDICARE: MRS. JOANNA BETH URETSKY N.P.
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
1363LF0000XFamily Nurse PractitionerR192388MD

General Provider Information

NPI Number : 1689920837
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JOANNA BETH URETSKY N.P.
Provider Business Mailing Address
First Line : 4315 SW IOWA ST
Second Line :
City : PORTLAND
State : OR
Zip : 97221-3468
Country : US
Telephone Number : 510-672-3447
Fax Number :
Provider Business Practice Location Address
First Line : 3060 SE HAWTHORNE BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97214-4121
Country : US
Telephone Number : 800-813-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2012
Last Update Date : 12/20/2021

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