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General NPI Number Information
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NPI Number | 1184371205
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Entity Type | Individual
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Provider Name | MONIQUE BIEGA NP
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Gender | Female
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Dates
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Enumeration Date | 03/08/2022
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Last Update Date | 03/08/2022
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Provider Practice Location Address
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Address Line | 5329 NE MARTIN LUTHER KING JR BLVD
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City | PORTLAND
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State | OR
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Zip | 97211-3237
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Country | US
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Telephone | 503-988-5558
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11568
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City | PORTLAND
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State | OR
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Zip | 97211-0568
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Country | US
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Telephone |
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 202114442NP-PP
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 202114442NP-PP
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License Number State | OR
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