Provider Demographics
NPI:1780914788
Name:APON, RENA (CRNA, PMHNP)
Entity type:Individual
Prefix:
First Name:RENA
Middle Name:
Last Name:APON
Suffix:
Gender:F
Credentials:CRNA, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12150 SW 1ST ST
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-2850
Mailing Address - Country:US
Mailing Address - Phone:503-530-8521
Mailing Address - Fax:
Practice Address - Street 1:12150 SW 1ST ST
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-2850
Practice Address - Country:US
Practice Address - Phone:503-530-8521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK98232367500000X
OR201060015CRNA367500000X
OR095000250390200000X
OR202211131NP-PP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program