Provider Demographics
NPI:1457535924
Name:NORBOM, LOWELL R (RN)
Entity Type:Individual
Prefix:
First Name:LOWELL
Middle Name:R
Last Name:NORBOM
Suffix:
Gender:M
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:PO BOX 165
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97018-0165
Mailing Address - Country:US
Mailing Address - Phone:503-397-3554
Mailing Address - Fax:
Practice Address - Street 1:33783 TIDE CREEK RD
Practice Address - Street 2:
Practice Address - City:DEER ISLAND
Practice Address - State:OR
Practice Address - Zip Code:97054-9536
Practice Address - Country:US
Practice Address - Phone:503-397-3554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health