Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 081035047N6 | OR |
NPI | 1023188653 |
---|---|
Provider Name | Ms. Nancy J. Pitney |
First Address | Portland, OR 97239-2674 |
Second Address | Portland, OR 97239-2674 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200897308 | (02) | OR |