Provider Demographics
NPI:1265633234
Name:EIGHMEY, CHRISTINE MARCOU (PNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARCOU
Last Name:EIGHMEY
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:GWENITH
Other - Middle Name:CHRISTINE
Other - Last Name:MARCOU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3181 SW SAM JACKSON PARK RD
Mailing Address - Street 2:MAIL CODE CDW 7
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3011
Mailing Address - Country:US
Mailing Address - Phone:503-494-7764
Mailing Address - Fax:503-494-6467
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:MAIL CODE CDW 7
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3011
Practice Address - Country:US
Practice Address - Phone:503-494-7764
Practice Address - Fax:503-494-6467
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201150135NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR201150135NPOtherLICENSE