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General NPI Number Information
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NPI Number | 1669886578
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Entity Type | Individual
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Provider Name | COURTNEY M. SUBUDHI DNP, CNM, FNP, PMHNP
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Gender | Female
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Dates
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Enumeration Date | 06/18/2014
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 7515 FALCON CREST DR
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City | REDMOND
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State | OR
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Zip | 97756-5014
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Country | US
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Telephone | 541-904-5216
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Fax |
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Provider Business Mailing Address
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Address Line | 7515 FALCON CREST DR
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City | REDMOND
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State | OR
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Zip | 97756-5014
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Country | US
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Telephone | 541-316-9447
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Fax | 541-527-4347
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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 | 0024173593
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 0024173593
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 202206897NP-PP
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License Number State | OR
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