Individual provider · NPI-1

Bethany Adams, DNP, AGACNP

Nurse Practitioner, Gerontology · Portland, OR

NPI number1053955047
StatusActive
Last updated in NPPESOct 27, 2023

Details

NPI
1053955047
Entity type
Individual (NPI-1)
Name
Bethany Adams
Credential
DNP, AGACNP
Sex
Female
Sole proprietor
No
Enumeration date
Nov 1, 2019
Certification date
Oct 27, 2023
Last updated
Oct 27, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LG0600X Nurse Practitioner, Gerontology201907743NP-PPORYes
163W00000X Registered Nurse201143042RNOR
163W00000X Registered Nurse33673AK
163W00000X Registered Nurse828531NV
363LA2100X Nurse Practitioner, Acute Care201907743NP-PPOR
363LG0600X Nurse Practitioner, Gerontology828531NV

Practice location

4805 Ne Glisan St
Portland, OR 97213-2933

Phone 503-215-2392

Mailing address

Po Box 3158
Portland, OR 97208-3158

Phone 503-215-6494

Other practice locations

1155 Mill St
Ms M-14
Reno, NV 89502-1576

Phone 775-982-5262 · Fax 775-982-4196

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