Leslie D Iverson, ARNP, MPH

Individual provider Active NPI Family Nurse Practitioner · Scappoose, OR

NPI 1174621676 · NPPES record last updated Sep 1, 2010

Key facts

NPI
1174621676
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
200350038NP (OR)
Practice address
51377 Old Portland Road
Suite C
Scappoose, OR 97056
Phone
(503) 418-4222
Fax
(503) 418-4223
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20250904000683 OR Order and Referring Only - Family Practice
Practitioner - Family Practice
7113073404

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 200350038NP OR Yes

Addresses

Primary practice location

51377 Old Portland Road
Suite C
Scappoose, OR 97056

Mailing address

51377 SW Old Portland Rd
Suite C
Scappoose, OR 97056-4018
Phone (503) 418-4222

Other providers in Scappoose, OR

All providers in Scappoose, OR · Family Nurse Practitioner in Oregon

Sources for this page

Verify at the official NPI Registry.