Provider Demographics
NPI:1043342884
Name:NURRE, NOELLE HASHIMOTO (PNP)
Entity Type:Individual
Prefix:MRS
First Name:NOELLE
Middle Name:HASHIMOTO
Last Name:NURRE
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:MRS
Other - First Name:NOELLE
Other - Middle Name:EMI
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PNP
Mailing Address - Street 1:6222 BARLOW ST
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-3040
Mailing Address - Country:US
Mailing Address - Phone:503-418-8208
Mailing Address - Fax:
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:MAIL CODE DC8N
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3011
Practice Address - Country:US
Practice Address - Phone:503-418-5196
Practice Address - Fax:503-418-5199
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR095000173RN163W00000X
OR095000173N2363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse