Provider Demographics
NPI:1336525047
Name:SHKURINSKY, ANNA (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:
Last Name:SHKURINSKY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14516 E BURNSIDE ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97233-2142
Mailing Address - Country:US
Mailing Address - Phone:503-253-9041
Mailing Address - Fax:503-254-2140
Practice Address - Street 1:14516 E BURNSIDE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233-2142
Practice Address - Country:US
Practice Address - Phone:503-253-9041
Practice Address - Fax:503-254-2140
Is Sole Proprietor?:No
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201142048RN163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR201142048RNOtherRN LICENSE NUMBER