Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 5970-33 | WI |
N | 363LA2100X | Nurse Practitioner - Acute Care | R 220478-1 | MN |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 201600814NP-PP | OR |
NPI | 1437554235 |
---|---|
Provider Name | Matthew Dunn |
First Address | Hillsboro, OR 97124-7721 |
Second Address | Portland, OR 97239-3011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2014 |
Last Update Date | 26/07/2019 |