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General NPI Number Information
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NPI Number | 1891535860
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Entity Type | Individual
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Provider Name | NATALYA TEBOR FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/28/2024
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Last Update Date | 05/28/2024
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Provider Practice Location Address
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Address Line | 220 A AVE STE 100
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City | LAKE OSWEGO
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State | OR
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Zip | 97034-3197
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Country | US
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Telephone | 971-224-7242
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Fax |
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Provider Business Mailing Address
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Address Line | 544 SE 69TH AVE
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City | PORTLAND
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State | OR
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Zip | 97215-2112
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Country | US
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Telephone | 971-235-8131
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 10026522
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License Number State | OR
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