Provider Demographics
NPI:1174594436
Name:NEWMAN, DAVID LAWRENCE (MSN, CFNP)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:LAWRENCE
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:MSN, CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2349 NE 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-4227
Mailing Address - Country:US
Mailing Address - Phone:503-282-1240
Mailing Address - Fax:
Practice Address - Street 1:5849 NE SANDY BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-3435
Practice Address - Country:US
Practice Address - Phone:503-251-8876
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR090006310N1FNPPP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily