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General NPI Number Information
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NPI Number | 1063711398
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Entity Type | Individual
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Provider Name | MAYA STROM FNP-C, DNP
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Gender | Female
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Dates
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Enumeration Date | 03/25/2011
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Last Update Date | 10/16/2021
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Provider Practice Location Address
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Address Line | 5935 SE BELMONT ST
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City | PORTLAND
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State | OR
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Zip | 97215-1925
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Country | US
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Telephone | 541-630-0870
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Fax |
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Provider Business Mailing Address
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Address Line | 5935 SE BELMONT ST
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City | PORTLAND
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State | OR
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Zip | 97215-1925
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Country | US
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Telephone | 541-638-0870
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Fax | 833-390-1391
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 201250074NP
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License Number State | OR
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