Provider Demographics
NPI:1467544833
Name:CHILDREN'S NURSING SPECIALTIES, INC.
Entity Type:Organization
Organization Name:CHILDREN'S NURSING SPECIALTIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:L
Authorized Official - Last Name:WULLBRANDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-968-2401
Mailing Address - Street 1:9900 SW GREENBURG RD
Mailing Address - Street 2:STE 290
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-5502
Mailing Address - Country:US
Mailing Address - Phone:503-968-2401
Mailing Address - Fax:503-968-2418
Practice Address - Street 1:9900 SW GREENBURG RD
Practice Address - Street 2:STE 290
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-5502
Practice Address - Country:US
Practice Address - Phone:503-968-2401
Practice Address - Fax:503-968-2418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15-2122251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care