Healthcare Provider Details

I. General information

NPI: 1881043057
Provider Name (Legal Business Name): EMILY CHRISTINE KRUMP R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY CHRISTINE NOXON

II. Dates (important events)

Enumeration Date: 06/08/2016
Last Update Date: 06/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12360 E BURNSIDE ST
PORTLAND OR
97233-1042
US

IV. Provider business mailing address

1050 NW ORDONEZ PL # 15301
BEAVERTON OR
97006-6052
US

V. Phone/Fax

Practice location:
  • Phone: 971-279-4800
  • Fax:
Mailing address:
  • Phone: 503-706-6611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number201603649RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: