Healthcare Provider Details

I. General information

NPI: 1730383787
Provider Name (Legal Business Name): MRS. LINDA LAWS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LINDA LAWS-KUSS RN

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 NE 202ND AVE
FAIRVIEW OR
97024-7805
US

IV. Provider business mailing address

3825 NE 202ND AVE P.O. BOX 1322
FAIRVIEW OR
97024-7805
US

V. Phone/Fax

Practice location:
  • Phone: 503-318-0576
  • Fax: 503-667-2701
Mailing address:
  • Phone: 503-318-0576
  • Fax: 503-667-2701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: