Anderson, Kori Lynn

Anderson, Kori Lynn is an individual health care provider with primary practice located at 4340 N Interstate Ave , Portland OR 97217-3211. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Anderson, Kori Lynn can be contacted via phone (503) 215-1444.

Contact Information

Primary practice address
4340 N Interstate Ave Portland OR 97217-3211
Phone: (503) 215-1444
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 200950022NP Oregon

Profile Details

NPI number 1043479389
LBN Legal business name Anderson, Kori Lynn
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2008
Last updated Oct 2nd, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043479389 NPPES
Oregon MEDICAID 500612457

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