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NPI Code Detail

MEDICARE: REBECCA FAULKNER APRN

MEDICARE:   REBECCA  FAULKNER  APRN
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAP8305AZ
2363LP0808XPsychiatric/Mental Health Nurse Practitioner202101730NP-PPOR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821419763
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA FAULKNER APRN
Provider Business Mailing Address
First Line : PO BOX 6149
Second Line :
City : ALOHA
State : OR
Zip : 97007-0149
Country : US
Telephone Number : 503-352-8642
Fax Number : 503-352-8658
Provider Business Practice Location Address
First Line : 2725 SW CEDAR HILLS BLVD STE 200
Second Line :
City : BEAVERTON
State : OR
Zip : 97005-1435
Country : US
Telephone Number : 503-352-6000
Fax Number : 503-352-6080
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2013
Last Update Date : 03/03/2021

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