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General NPI Number Information
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NPI Number | 1710318654
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Entity Type | Individual
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Provider Name | MAREE ELIZABETH PURDY ARNP
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Gender | Female
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Dates
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Enumeration Date | 12/03/2013
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Last Update Date | 07/11/2016
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Provider Practice Location Address
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Address Line | 10250 SW GREENBURG RD STE 110
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City | PORTLAND
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State | OR
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Zip | 97223-5469
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Country | US
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Telephone | 503-293-4055
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Fax | 503-293-8332
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Provider Business Mailing Address
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Address Line | 10250 SW GREENBURG RD STE 110
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City | PORTLAND
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State | OR
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Zip | 97223-5469
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Country | US
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Telephone | 503-293-4055
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Fax | 503-293-8332
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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 | AP60479342
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201403441NP-PP
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License Number State | OR
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