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General NPI Number Information
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NPI Number | 1427653153
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Entity Type | Individual
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Provider Name | BATHSHEBA SHUNQUITA QUEEN BSN, MSN
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Gender | Female
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Dates
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Enumeration Date | 12/01/2020
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 216 S 2ND ST UNIT 183
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City | INDEPENDENCE
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State | OR
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Zip | 97351-2081
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Country | US
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Telephone | 352-321-0554
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Fax |
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Provider Business Mailing Address
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Address Line | 1027 E BURNSIDE ST
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City | PORTLAND
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State | OR
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Zip | 97214-1328
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Country | US
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Telephone | 503-239-8400
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Fax | 503-239-8407
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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 | 10038858
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | NP95015951
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | NP95015951
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | NP95015951
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 10038858
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License Number State | OR
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Taxonomy #6
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 10038858
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License Number State | OR
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