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General NPI Number Information
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NPI Number | 1558644955
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Entity Type | Individual
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Provider Name | ELLEN CARLA BARKER-ANDERSON APNP
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Gender | Female
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Dates
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Enumeration Date | 09/21/2011
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Last Update Date | 06/17/2021
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Provider Practice Location Address
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Address Line | 833 SW 11TH AVE STE 245
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City | PORTLAND
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State | OR
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Zip | 97205-2132
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Country | US
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Telephone | 503-442-6105
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Fax | 503-234-7166
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Provider Business Mailing Address
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Address Line | 833 SW 11TH AVE STE 245
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City | PORTLAND
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State | OR
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Zip | 97205-2132
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Country | US
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Telephone | 503-442-6105
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Fax | 503-234-7166
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 201601411
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License Number State | OR
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