Provider Demographics
NPI:1669524625
Name:ANDERSON, HELEN MARIE (RN)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:MARIE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14391 SW BARROWS RD
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-6136
Mailing Address - Country:US
Mailing Address - Phone:503-830-7683
Mailing Address - Fax:503-524-7954
Practice Address - Street 1:14391 SW BARROWS RD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-6136
Practice Address - Country:US
Practice Address - Phone:503-830-7683
Practice Address - Fax:503-524-7954
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR098275Medicaid