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General NPI Number Information
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NPI Number | 1265887335
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Entity Type | Individual
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Provider Name | AMY HUMPHREY DNP, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/26/2016
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Last Update Date | 09/17/2020
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Provider Practice Location Address
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Address Line | 5 CENTERPOINTE DR STE 600
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City | LAKE OSWEGO
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State | OR
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Zip | 97035-8662
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Country | US
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Telephone | 503-351-1278
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Fax | 866-770-2037
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Provider Business Mailing Address
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Address Line | 1055 NE CREEKSEDGE DR
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City | HILLSBORO
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State | OR
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Zip | 97124-1316
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP8622
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201800084NP
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License Number State | OR
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