Healthcare Provider Details

I. General information

NPI: 1659473189
Provider Name (Legal Business Name): BARBARA THERESA TROXEL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2006
Last Update Date: 03/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 NW COUNCIL DR SUITE 300
GRESHAM OR
97030-3721
US

IV. Provider business mailing address

831 NW COUNCIL DR SUITE 300
GRESHAM OR
97030-3721
US

V. Phone/Fax

Practice location:
  • Phone: 503-382-8100
  • Fax: 503-382-8120
Mailing address:
  • Phone: 503-382-8100
  • Fax: 503-382-8120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number081001341N3ANPPP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: