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General NPI Number Information
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NPI Number | 1609595297
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Entity Type | Organization
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Legal Business Name | DAUGHTERS OF ASCLEPIUS LLC
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Dates
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Enumeration Date | 08/25/2022
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 17050 PILKINGTON RD STE 220
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City | LAKE OSWEGO
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State | OR
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Zip | 97035-6309
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Country | US
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Telephone | 564-225-0966
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Fax | 866-522-6255
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Provider Business Mailing Address
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Address Line | 17050 PILKINGTON RD STE 220
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City | LAKE OSWEGO
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State | OR
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Zip | 97035-6309
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Country | US
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Telephone | 564-225-0966
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Fax | 866-522-6255
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Authorized Official
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Title or Position | FOUNDER, CEO
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Name | JAMIE D COCHRAN
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Credential | MSN, FNP-C
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Telephone | 564-225-0966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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