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General NPI Number Information
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NPI Number | 1518530716
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Entity Type | Individual
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Provider Name | CHRISTINE PRENTICE APRN-RX
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Gender | Female
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Dates
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Enumeration Date | 07/23/2021
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 19365 SW 65TH AVE STE 100
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City | TUALATIN
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State | OR
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Zip | 97062-9196
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Country | US
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Telephone | 971-378-2269
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Fax |
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Provider Business Mailing Address
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Address Line | 19365 SW 65TH AVE STE 100
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City | TUALATIN
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State | OR
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Zip | 97062-9196
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Country | US
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Telephone | 971-378-2269
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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 | APRN-3245-0
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 10046190
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 889347
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 70005420
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License Number State | WA
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