Johnsrud, Penny
Johnsrud, Penny is an individual health care provider with primary practice located at 501 Ne Hood Ave Suite 100, Gresham OR 97030-7303. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Johnsrud, Penny can be contacted via phone (503) 775-4931.Contact Information
Primary practice address
501 Ne Hood Ave Suite 100
Gresham OR 97030-7303
Phone: (503) 775-4931
Fax: (503) 788-7285
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 095006656N1 | Oregon |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | AP30005364 | Washington |
Profile Details
| NPI number | 1851317598 |
|---|---|
| LBN Legal business name | Johnsrud, Penny |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 14th, 2006 |
| Last updated | Nov 11th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851317598 | NPPES |
| Washington | MEDICAID | 9636119 | |
| Washington | MEDICAID | 212335 |
Popular Providers
-
Dembrow, Tatyana J
501 Ne Hood Ave Suite 100, Gresham OR 97030-7303 -
Maxwell, Charlene Afable
600 Ne 8Th St #300, Gresham OR 97030-7317 -
Proctor, Julie A
24800 Se Stark St , Gresham OR 97030-3378 -
Freed, Shelby Lee
600 Ne 8Th St Ste. 300, Gresham OR 97030-7317 -
Martinez, Rebecca
600 Ne 8Th, 3Rd Floor , Gresham OR 97030 -
Salter, Daniel Thomas Matthew
2850 Se Powell Valley Rd , Gresham OR 97080-1494 -
Radford, Tami L
831 Nw Council Dr Ste 125 , Gresham OR 97030 -
Johnson, Debra F
831 Nw Council Dr Suite 101, Gresham OR 97030-3721