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Laurel Katherine Hallock Koppelman, FNP-C
Family Nurse Practitioner in Portland, Oregon
NPI 1942623764

Laurel Katherine Hallock Koppelman is a Family Nurse Practitioner based in Portland, OR and is specialized in Family. Laurel Katherine Hallock Koppelman practices in Portland, OR and has the professional credentials of FNP-C. The NPI Number for Laurel Katherine Hallock Koppelman is 1942623764 and holds a License No. 201392556 (Oregon).

The current practice location address for Laurel Katherine Hallock Koppelman is 12720 Se Division Street, Portland, OR and can be reached out via phone at 503-988-3601.

Location: 12720 Se Division Street, Portland, OR, 97204-1817
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Provider Profile Details
NPI Number
1942623764
Provider Name
Laurel Katherine Hallock Koppelman
Credential
FNP-C
Provider Entity Type
Individual
Gender
Female
Address
12720 Se Division Street, Portland, OR, 97204-1817
Phone Number
503-988-3601
Fax Number
Provider Enumeration Date
01/30/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
096511 05 OR
22959 05 OR
institution
Provider Business Practice Location Address Details
Address
12720 Se Division Street
City
State
Zip
97236
Phone Number
503-988-3601
Fax Number
person
Provider Business Mailing Address Details
Address
12720 Se Division Street
City
State
Zip
97236
Phone Number
503-988-3601
Fax Number
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Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
201392556 (Oregon)
Definition
Definition to come...
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