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General NPI Number Information
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NPI Number | 1740859297
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Entity Type | Individual
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Provider Name | DANIELA FAWCETT FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/20/2021
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Last Update Date | 09/27/2024
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Provider Practice Location Address
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Address Line | 5200 MEADOWS RD STE 200
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City | LAKE OSWEGO
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State | OR
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Zip | 97035-0086
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Country | US
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Telephone | 855-255-1750
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Fax | 855-255-0905
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Provider Business Mailing Address
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Address Line | 15352 SE ARROWHEAD PL
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City | HAPPY VALLEY
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State | OR
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Zip | 97086-7379
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Country | US
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Telephone | 310-384-6520
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP61522042
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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 | 10019434
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP61522042
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95017430
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 10019434
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License Number State | OR
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