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General NPI Number Information
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NPI Number | 1689950586
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Entity Type | Organization
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Legal Business Name | BETHANY ROWLAND PMHNP
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Dates
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Enumeration Date | 10/25/2011
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Last Update Date | 10/25/2011
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Provider Practice Location Address
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Address Line | 921 SW WASHINGTON ST SUITE 812
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City | PORTLAND
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State | OR
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Zip | 97205-2827
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Country | US
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Telephone | 503-224-5808
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Fax | 503-916-8181
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Provider Business Mailing Address
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Address Line | 921 SW WASHINGTON ST SUITE 812
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City | PORTLAND
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State | OR
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Zip | 97205-2827
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Country | US
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Telephone | 503-224-5808
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Fax | 503-916-8181
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Authorized Official
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Title or Position | SOLE PRACTITIONER
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Name | BETHANY SUZANNE ROWLAND
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Credential | PMHNP
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Telephone | 503-224-5808
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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 | 080-044756N6
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License Number State | OR
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