Provider Demographics
NPI:1639450471
Name:GRIFFITHS, DENISE LEE (FNP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:LEE
Last Name:GRIFFITHS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:LEE
Other - Last Name:MENSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 765
Mailing Address - Street 2:
Mailing Address - City:CHRISTMAS VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97641-0765
Mailing Address - Country:US
Mailing Address - Phone:541-219-2623
Mailing Address - Fax:
Practice Address - Street 1:87520 BAY RD
Practice Address - Street 2:
Practice Address - City:CHRISTMAS VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97641-2233
Practice Address - Country:US
Practice Address - Phone:541-536-3435
Practice Address - Fax:541-536-1040
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201150108NP363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500656255Medicaid