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General NPI Number Information
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NPI Number | 1013020429
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Entity Type | Organization
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Legal Business Name | DEBORAH K RUPAE FNP, PLLC
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 04/24/2008
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Provider Practice Location Address
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Address Line | 1405 SE 164TH AVE SUITE 201
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City | VANCOUVER
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State | WA
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Zip | 98683-9644
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Country | US
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Telephone | 360-891-0505
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Fax | 360-891-0730
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Provider Business Mailing Address
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Address Line | PO BOX 23200
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City | PORTLAND
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State | OR
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Zip | 97281-3200
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Country | US
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Telephone | 360-891-0505
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Fax | 360-891-0730
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Authorized Official
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Title or Position | MEMBER
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Name | DEBORAH RUPAE
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Credential | FNP
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Telephone | 360-891-0505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP30005854
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License Number State | WA
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