Provider Demographics
NPI:1003291584
Name:TORVIK, MOLLY K (NP)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:K
Last Name:TORVIK
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61141 S HWY 97 STE 173
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-2523
Mailing Address - Country:US
Mailing Address - Phone:541-204-2021
Mailing Address - Fax:541-325-4011
Practice Address - Street 1:1345 NW WALL ST STE 202
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-1967
Practice Address - Country:US
Practice Address - Phone:541-204-2021
Practice Address - Fax:541-325-4011
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-24
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201505052NP-PP363L00000X
OR2024070617363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner