person
Mr. Elliott Louis Koivisto, NP
Psychiatric/Mental Health Nurse Practitioner in Tigard, Oregon
NPI 1407592397

Elliott Louis Koivisto is a Psychiatric/Mental Health Nurse Practitioner based in Beaverton, OR and is specialized in Psychiatric/Mental Health. Elliott Louis Koivisto practices in Tigard, OR and has the professional credentials of NP. The NPI Number for Elliott Louis Koivisto is 1407592397 and holds a License No. AP61377025 (Oregon).

The current practice location address for Elliott Louis Koivisto is 7145 Sw Varns St Ste 206, Tigard, OR and can be reached out via phone at 971-405-2584 and via fax at 800-785-4531.

Location: 7145 Sw Varns St Ste 206, Tigard, OR, 97008-7949
person
Provider Profile Details
NPI Number
1407592397
Provider Name
Elliott Louis Koivisto
Credential
NP
Provider Entity Type
Individual
Gender
Male
Address
7145 Sw Varns St Ste 206, Tigard, OR, 97008-7949
Phone Number
971-405-2584
Fax Number
800-785-4531
Provider Enumeration Date
05/12/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
201390875RN 01 OR OREGON STATE NURSING LICENSE NUMBER
RN60545376 01 WA WASHINGTON STATE DEPARTMENT OF HEALTH
AP61377025 01 WA WASHINGTON STATE DEPARTMENT OF HEALTH
10005745 01 OR OREGON STATE NURSING LICENSE
institution
Provider Business Practice Location Address Details
Address
7145 Sw Varns St Ste 206
City
State
Zip
97223-8168
Phone Number
971-405-2584
Fax Number
800-785-4531
person
Provider Business Mailing Address Details
Address
7145 Sw Varns St Ste 206
City
State
Zip
97223-8168
Phone Number
971-405-2584
Fax Number
800-785-4531
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
AP61377025 (Washington)
Definition
Definition to come...
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