Healthcare Provider Details

I. General information

NPI: 1245726694
Provider Name (Legal Business Name): DANIELLE RENE GLOVER-CLOUTIER BSN, DNP, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2018
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1639 SE ENSIGN LN STE B103
WARRENTON OR
97146-7308
US

IV. Provider business mailing address

2111 EXCHANGE ST
ASTORIA OR
97103-3329
US

V. Phone/Fax

Practice location:
  • Phone: 503-338-4500
  • Fax: 503-338-4501
Mailing address:
  • Phone: 503-325-4321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number201907544NP-PP
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60883490
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: