Healthcare Provider Details

I. General information

NPI: 1982126561
Provider Name (Legal Business Name): JANET MEYERS VANONI RN, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 NW 22ND AVE STE LL10
PORTLAND OR
97210-2974
US

IV. Provider business mailing address

1130 NW 22ND AVE STE LL10
PORTLAND OR
97210-2974
US

V. Phone/Fax

Practice location:
  • Phone: 503-413-8050
  • Fax: 503-413-6872
Mailing address:
  • Phone: 503-413-8050
  • Fax: 503-413-6872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number094006312RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: