Provider Demographics
NPI:1437910239
Name:YOUNG, SONJA (RN)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:
Last Name:YOUNG
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 1:28233 SW LADD HILL RD
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-5016
Mailing Address - Country:US
Mailing Address - Phone:503-997-2764
Mailing Address - Fax:
Practice Address - Street 1:2100 W END AVE STE 750
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-5233
Practice Address - Country:US
Practice Address - Phone:503-997-2764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKNURR30969163WP0808X
OR10007300163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health