Provider Demographics
NPI:1104970508
Name:AUERBACH, ROMNEE LYNN (ANP-BC,PMHS,PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:ROMNEE
Middle Name:LYNN
Last Name:AUERBACH
Suffix:
Gender:F
Credentials:ANP-BC,PMHS,PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-2909
Mailing Address - Country:US
Mailing Address - Phone:503-538-4874
Mailing Address - Fax:503-538-1271
Practice Address - Street 1:501 E 1ST ST
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-2909
Practice Address - Country:US
Practice Address - Phone:503-378-4874
Practice Address - Fax:503-378-1271
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2015-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200650168NP363LP0808X
OR088000343N3363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR165554Medicaid