Provider Demographics
NPI:1083345615
Name:COURSER, NATOSHA LEE-ANNE
Entity Type:Individual
Prefix:
First Name:NATOSHA
Middle Name:LEE-ANNE
Last Name:COURSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 913
Mailing Address - Street 2:
Mailing Address - City:RAINIER
Mailing Address - State:OR
Mailing Address - Zip Code:97048-0913
Mailing Address - Country:US
Mailing Address - Phone:503-369-5039
Mailing Address - Fax:
Practice Address - Street 1:271 COLUMBIA BLVD
Practice Address - Street 2:
Practice Address - City:SAINT HELENS
Practice Address - State:OR
Practice Address - Zip Code:97051-2021
Practice Address - Country:US
Practice Address - Phone:503-397-0391
Practice Address - Fax:503-366-1067
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator