Healthcare Provider Details

I. General information

NPI: 1922910454
Provider Name (Legal Business Name): JOSHUA W CORDER RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 SOUTH ST
ASTORIA OR
97103-5551
US

IV. Provider business mailing address

325 SOUTH ST
ASTORIA OR
97103-5551
US

V. Phone/Fax

Practice location:
  • Phone: 971-704-6100
  • Fax:
Mailing address:
  • Phone: 971-704-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number201505766RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: