| Doctor Name: | BETTY ZONDERVAN |
| NPI Number: | 1003945544 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 98006796 |
| Business Practice Address: | 14255 Sw Brigadoon Ct Beaverton, OR - 970053369 |
| Business Phone Number: | 5036411475 |
| Business Fax Number: | 5036418548 |
| Mailing Address: | 14600 Nw Cornell Rd, PORTLAND |
| State: | OR |
| Postal Code: | 972295442 |
| Phone Number: | 5036453581 |
| Fax Number: | 5035330152 |
| NPI Enumeration Date: | 03/02/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | 98006796 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |