Individual provider · Type 1 NPI

Irena Mattingly, AGNP-C

Primary Care Nurse Practitioner · Portland, OR

NPI number 1457040818 Active

Practice location

6214 SE Milwaukie Ave
Portland, OR 97202-5417

Fax (225) 351-9980

Mailing address

6812 SE Drew St
Milwaukie, OR 97222-1830

Specialties and licenses

TaxonomyCodeLicense
Primary Care Nurse Practitioner Primary 363LP2300X10007639 (OR)

Primary Care Nurse Practitioner: Definition to come...

14 other providers at this address

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About NPI 1457040818

Irena Mattingly, AGNP-C's National Provider Identifier is 1457040818, issued on May 2, 2023. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Portland, OR. The record was last updated on Nov 4, 2024.