Healthcare Provider Details

I. General information

NPI: 1376344192
Provider Name (Legal Business Name): EMILY WARD MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2025
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 NE 6TH AVE
ESTACADA OR
97023-9312
US

IV. Provider business mailing address

PO BOX 546
GRESHAM OR
97030-0132
US

V. Phone/Fax

Practice location:
  • Phone: 503-630-8550
  • Fax:
Mailing address:
  • Phone: 971-373-4165
  • Fax: 503-862-5060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10041903
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: