Individual provider · Type 1 NPI
Corey Elizabeth Watson
Psychiatric/Mental Health Nurse Practitioner · Portland, OR
NPI number
1083078265
Active
Practice location
1225 NE 2nd Ave
Portland, OR 97232
Fax (503) 944-8017
Mailing address
PO Box 4399
Portland, OR 97208-4399
Other practice locations
- 800 E 28th St Ste 600, Minneapolis, MN 55407 · (612) 863-5327
- 800 E 28th St Ste 600, Minneapolis, MN 55407 · (612) 863-5327
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | 2016012318 (MN) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 234275-3 (MN) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 201810266NP-PP (OR) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1083078265
Corey Elizabeth Watson's National Provider Identifier is 1083078265, issued on Apr 13, 2016. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Portland, OR. The record was last updated on Apr 8, 2019.