Provider Demographics
NPI:1568407708
Name:VOS, VERA (FNP)
Entity Type:Individual
Prefix:
First Name:VERA
Middle Name:
Last Name:VOS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 NW LOVEJOY ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-1516
Mailing Address - Country:US
Mailing Address - Phone:503-227-0350
Mailing Address - Fax:503-227-0745
Practice Address - Street 1:2050 NW LOVEJOY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-1516
Practice Address - Country:US
Practice Address - Phone:503-227-0350
Practice Address - Fax:503-227-0745
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200250061NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR000630Medicaid
ORR161574Medicare PIN
ORRR PTAN 500028207Medicare PIN
ORR114179Medicare PIN
OR000630Medicaid
P70235Medicare UPIN