Provider Demographics
NPI:1467266783
Name:HULL, BETHANY LOUISE (RN)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:LOUISE
Last Name:HULL
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 1:52490 SE 2ND ST STE 140
Mailing Address - Street 2:
Mailing Address - City:SCAPPOOSE
Mailing Address - State:OR
Mailing Address - Zip Code:97056-3641
Mailing Address - Country:US
Mailing Address - Phone:503-396-0830
Mailing Address - Fax:503-396-0830
Practice Address - Street 1:52490 SE 2ND ST STE 140
Practice Address - Street 2:
Practice Address - City:SCAPPOOSE
Practice Address - State:OR
Practice Address - Zip Code:97056-3641
Practice Address - Country:US
Practice Address - Phone:503-396-0830
Practice Address - Fax:503-396-0830
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15-2473253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care