Provider Demographics
NPI:1336795228
Name:TORRES, KATHY ELAINE (RN BSN)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:ELAINE
Last Name:TORRES
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 N ANCHOR WAY UNIT 408
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-7531
Mailing Address - Country:US
Mailing Address - Phone:971-998-3714
Mailing Address - Fax:
Practice Address - Street 1:420 NE MASON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211-3479
Practice Address - Country:US
Practice Address - Phone:503-546-9292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200541641RN163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology