IndividualActive
Katherine Edstrom, AGNP-C
NPI 1043862550 · Gerontology Nurse Practitioner · Portland, OR
Provider details
- NPI number
- 1043862550
- Entity type
- Individual
- Primary specialty
- Gerontology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- AGNP-C
- Sex
- Female
- Sole proprietor
- Yes
- License
- 201905490NP-PP (OR)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
5100 S Macadam Ave Ste 200
Portland, OR 97239-3827
Phone: (971) 202-5500
Fax: (971) 202-5555
Approximate (ZIP-level) locationGet directions
Mailing address
3181 Sw Sam Jackson Park Rd
Portland, OR 97239-3011
Additional practice locations (1)
- 3181 Sw Sam Jackson Park RdPortland, OR 97239-3011Phone: (503) 494-8562Fax: (503) 418-5505
Registry dates
- Enumerated
- 2019-07-15
- Last updated
- 2024-05-17
- Certified
- 2024-05-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.