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NPI Code Detail

MEDICARE: BETH OTT RN

MEDICARE: BETH OTT RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WG0000XGeneral Practice Registered Nurse200441144RNOR

General Provider Information

NPI Number : 1043173818
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETH OTT RN
Provider Business Mailing Address
First Line : 5555 NE ELAM YOUNG PKWY
Second Line :
City : HILLSBORO
State : OR
Zip : 97124-6452
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5555 NE ELAM YOUNG PKWY
Second Line :
City : HILLSBORO
State : OR
Zip : 97124-6452
Country : US
Telephone Number : 503-216-1600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2025
Last Update Date : 12/08/2025

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