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General NPI Number Information
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NPI Number | 1467462580
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Entity Type | Individual
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Provider Name | BEVERLY M STEWART ARNP
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Gender | Female
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 05/22/2008
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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 | 503-775-4931
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Fax | 503-788-7285
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Provider Business Mailing Address
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Address Line | 4545 SW STEPHENSON ST
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City | PORTLAND
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State | OR
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Zip | 97219-7109
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Country | US
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Telephone | 503-293-3122
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Fax | 503-788-7285
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP30006817RN00156781
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License Number State | WA
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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 | AP30006817RN00156781
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP30006817RN00156781
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | AP30006817RN00156781
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License Number State | WA
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