Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 201802826NP-PP | OR |
NPI | 1023439940 |
---|---|
Provider Name | Mrs. Nelda Ogden |
First Address | Vancouver, WA 98683-8004 |
Second Address | Eugene, OR 97402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2013 |
Last Update Date | 11/06/2018 |