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NPI Code Detail

MEDICARE: KIRBY ORR PMHNP

MEDICARE: KIRBY ORR PMHNP
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 Practitioner10036508OR

General Provider Information

NPI Number : 1871326215
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIRBY ORR PMHNP
Provider Business Mailing Address
First Line : 15211 NE 72ND AVE STE A
Second Line :
City : VANCOUVER
State : WA
Zip : 98686-1929
Country : US
Telephone Number : 360-209-4449
Fax Number :
Provider Business Practice Location Address
First Line : 15211 NE 72ND AVE STE A
Second Line :
City : VANCOUVER
State : WA
Zip : 98686-1929
Country : US
Telephone Number : 360-209-4449
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2024
Last Update Date : 01/10/2025

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