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NPI Code Detail

MEDICARE: ELISA ANN ENGBRETSON NP

MEDICARE:   ELISA ANN ENGBRETSON  NP
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
1363LF0000XFamily Nurse Practitioner200150128NPOR

General Provider Information

NPI Number : 1356396733
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISA ANN ENGBRETSON NP
Provider Business Mailing Address
First Line : 2051 KAEN RD
Second Line : SUITE 367
City : OREGON CITY
State : OR
Zip : 97045-4035
Country : US
Telephone Number : 503-742-5300
Fax Number : 503-742-5979
Provider Business Practice Location Address
First Line : 1425 BEAVERCREEK RD
Second Line :
City : OREGON CITY
State : OR
Zip : 97045-4076
Country : US
Telephone Number : 503-655-8471
Fax Number : 503-723-4946
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2006
Last Update Date : 10/18/2016

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Directions to “ ELISA ANN ENGBRETSON NP” Practice Location

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