Provider Demographics
NPI:1619930138
Name:NEPVEU, LAURA (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:NEPVEU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19250 SW 65TH AVE
Mailing Address - Street 2:SUITE #255
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-7452
Mailing Address - Country:US
Mailing Address - Phone:503-692-5300
Mailing Address - Fax:503-692-5331
Practice Address - Street 1:19250 SW 65TH AVE
Practice Address - Street 2:SUITE #255
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-7452
Practice Address - Country:US
Practice Address - Phone:503-692-5300
Practice Address - Fax:503-692-5331
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD18304207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR370014245OtherRAILROAD MEDICARE
OR073200Medicaid
OR073200Medicaid
ORR144380Medicare PIN