Provider Demographics
NPI:1053358705
Name:MARTO, KAREN (FNP)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:MARTO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 SW 257TH AVE
Mailing Address - Street 2:
Mailing Address - City:TROUTDALE
Mailing Address - State:OR
Mailing Address - Zip Code:97060-1900
Mailing Address - Country:US
Mailing Address - Phone:503-669-6800
Mailing Address - Fax:503-492-1352
Practice Address - Street 1:1700 SW 257TH AVE
Practice Address - Street 2:
Practice Address - City:TROUTDALE
Practice Address - State:OR
Practice Address - Zip Code:97060-1900
Practice Address - Country:US
Practice Address - Phone:503-669-6800
Practice Address - Fax:503-491-2434
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR081046966N1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK23736Medicaid
OR271201Medicaid
ORR105622Medicare UPIN
OR500026088Medicare ID - Type UnspecifiedRAILROAD MEDICARE
S92573Medicare UPIN