Healthcare Provider Details

I. General information

NPI: 1932032745
Provider Name (Legal Business Name): SAMANTHA TRAMMELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19500 SW 90TH CT
TUALATIN OR
97062-7505
US

IV. Provider business mailing address

12875 SW CRESCENT ST APT 320
BEAVERTON OR
97005-1792
US

V. Phone/Fax

Practice location:
  • Phone: 503-614-1790
  • Fax:
Mailing address:
  • Phone: 503-757-6385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number201901140RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: