Provider Demographics
NPI:1467757005
Name:DENNISON, ROBIN LEE (RN)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:LEE
Last Name:DENNISON
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 1:6455 SW NYBERG LN
Mailing Address - Street 2:APT J211
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-9704
Mailing Address - Country:US
Mailing Address - Phone:971-570-7316
Mailing Address - Fax:
Practice Address - Street 1:6455 SW NYBERG LN
Practice Address - Street 2:APT J211
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-9704
Practice Address - Country:US
Practice Address - Phone:971-570-7316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200440872RN163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management