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NPI Code Detail

MEDICARE: SARAH CAMP FNP

MEDICARE: SARAH CAMP FNP
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 Practitioner089006551N1OR

General Provider Information

NPI Number : 1447381165
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH CAMP FNP
Provider Business Mailing Address
First Line : 12220 SW 1ST ST STE 200
Second Line :
City : BEAVERTON
State : OR
Zip : 97005-2890
Country : US
Telephone Number : 503-775-4931
Fax Number : 503-788-7285
Provider Business Practice Location Address
First Line : 3727 NE MARTIN LUTHER KING JR BLVD
Second Line : ATTN: CREDENTIALING
City : PORTLAND
State : OR
Zip : 97212-1112
Country : US
Telephone Number : 503-775-4931
Fax Number : 503-788-7285
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2007
Last Update Date : 01/10/2012

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