Healthcare Provider Details

I. General information

NPI: 1427604586
Provider Name (Legal Business Name): ERIN JOY WARREN PNP-AC/PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2019
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19250 SW 65TH AVE STE 100
TUALATIN OR
97062-7707
US

IV. Provider business mailing address

19250 SW 65TH AVE STE 100
TUALATIN OR
97062-7707
US

V. Phone/Fax

Practice location:
  • Phone: 503-691-2519
  • Fax: 503-659-8984
Mailing address:
  • Phone: 503-691-2519
  • Fax: 503-659-8984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number201810268NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: