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General NPI Number Information
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NPI Number | 1346590239
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Entity Type | Individual
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Provider Name | LENA CRANDELL WHNP
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Gender | Female
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 09/19/2012
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Provider Practice Location Address
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Address Line | 3231 SE 50TH AVE
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City | PORTLAND
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State | OR
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Zip | 97206-2248
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Country | US
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Telephone | 617-733-6363
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Fax |
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Provider Business Mailing Address
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Address Line | 3727 NE MARTIN LUTHER KING JR BLVD
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City | PORTLAND
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State | OR
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Zip | 97212-1112
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Country | US
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Telephone | 617-733-6363
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 201250131NP
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License Number State | OR
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