Provider Demographics
NPI:1831144427
Name:MURPHY, PATRICIA A (ANP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:MURPHY
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:A
Other - Last Name:MOUNSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP
Mailing Address - Street 1:1254 SW CARDINELL DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-6761
Mailing Address - Country:US
Mailing Address - Phone:503-297-1607
Mailing Address - Fax:
Practice Address - Street 1:1254 SW CARDINELL DR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97201-6761
Practice Address - Country:US
Practice Address - Phone:503-297-1607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR085082366N3363LA2200X
WAAP30003745363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR077169Medicaid
ORMM0598118OtherDEA
OR108586Medicare ID - Type Unspecified
ORP23867Medicare UPIN