Individual provider · Type 1 NPI
Wendy Osorio Domreis, PNP
Pediatric Nurse Practitioner · Portland, OR
NPI number
1689689192
Active
Practice location
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Mailing address
11025 SW Esquiline Circus
Portland, OR 97219-7876
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 098006824RN (OR) |
| Pediatric Nurse Practitioner Primary | 363LP0200X | 200350089NP (OR) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1689689192
Wendy Osorio Domreis, PNP's National Provider Identifier is 1689689192, issued on Jul 31, 2006. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Portland, OR. The record was last updated on Dec 20, 2011.