Search › Oregon › 363LA2100X
Staci Colovos, ACNP
NPI 1366786261 · on the registry since 2012 · sole proprietor
Practice
- Address
- 3303 S Bond Ave
Portland, OR 97239 - Phone
- (503) 494-7246
- Fax
- (503) 346-6961
- Organisation at this address
- University Professional Services
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 210
Additional practice sites
- 4401 Harrison Blvd, Ogden, UT
Registry record
- Primary taxonomy
- 363LA2100X
363LA2100X
- Also registered as
- 363L00000X
363LA2100X - Licence states on file
- OR, UT
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-08-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon