Healthcare Provider Details

I. General information

NPI: 1932619590
Provider Name (Legal Business Name): COURTNEY SZPER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2017
Last Update Date: 10/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 NE DIVISION ST FL 1
GRESHAM OR
97030-4617
US

IV. Provider business mailing address

4101 NE DIVISION ST FL 1
GRESHAM OR
97030-4617
US

V. Phone/Fax

Practice location:
  • Phone: 503-666-3808
  • Fax: 503-666-6835
Mailing address:
  • Phone: 503-666-3808
  • Fax: 503-666-6835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number201706978RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: