IndividualActive
Gwen Sampson
NPI 1558812867 · Gerontology Nurse Practitioner · Beaverton, OR
Provider details
- NPI number
- 1558812867
- Entity type
- Individual
- Primary specialty
- Gerontology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 26NJ00678600 (NJ)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
6800 Sw 105th Ave Ste 206
Beaverton, OR 97008-5487
Phone: (503) 430-1777
Fax: (503) 372-5119
Approximate (ZIP-level) locationGet directions
Mailing address
6800 Sw 105th Ave Ste 206
Beaverton, OR 97008-5487
Registry dates
- Enumerated
- 2016-10-21
- Last updated
- 2023-04-06
- Certified
- 2023-04-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.