Provider Demographics
NPI:1598191215
Name:HAFNER, ROMY LEE (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:ROMY
Middle Name:LEE
Last Name:HAFNER
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:ROMY
Other - Middle Name:LEE
Other - Last Name:ROMANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10151 SE SUNNYSIDE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-5705
Mailing Address - Country:US
Mailing Address - Phone:036-590-8805
Mailing Address - Fax:
Practice Address - Street 1:10151 SE SUNNYSIDE RD STE 100
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-5705
Practice Address - Country:US
Practice Address - Phone:036-590-8805
Practice Address - Fax:503-513-7425
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK100763363LF0000X
OR201902105NP-PP363LF0000X
WAAP60927292363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily