Provider Demographics
NPI:1225326002
Name:PAPE, CHARITY GRACE (RN)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:GRACE
Last Name:PAPE
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 1:1625 SE BIDWELL ST
Mailing Address - Street 2:UNIT 7
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-6156
Mailing Address - Country:US
Mailing Address - Phone:541-556-5995
Mailing Address - Fax:
Practice Address - Street 1:1625 SE BIDWELL ST
Practice Address - Street 2:UNIT 7
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-6156
Practice Address - Country:US
Practice Address - Phone:541-556-5995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201141696RN163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health