Individual provider · Type 1 NPI
Gwen Sampson
Gerontology Nurse Practitioner · Beaverton, OR
NPI number
1558812867
Active
Practice location
6800 SW 105th Ave Ste 206
Beaverton, OR 97008-5487
Fax (503) 372-5119
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 26NJ00678600 (NJ) |
| Gerontology Nurse Practitioner | 363LG0600X | 26NJ00678600 (NJ) |
| Gerontology Nurse Practitioner Primary | 363LG0600X | 201703018NP-PP (OR) |
Gerontology Nurse Practitioner: Definition to come...
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About NPI 1558812867
Gwen Sampson's National Provider Identifier is 1558812867, issued on Oct 21, 2016. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Beaverton, OR. The record was last updated on Apr 6, 2023.