HOLLY P JASTAK (NPI# 1023541869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1023541869 |
Entity Type | Individual |
Full Name | HOLLY P JASTAK |
Credential | RN, MSN, FNP |
Practice Address |
2800 N Vancouver Ave Ste 165 Portland OR 97227-1644 |
Mailing Address |
Po Box 4399 Portland OR 97208-4399 |
Practice Telephone | 5034132902 |
Practice Fax Number | 5034135220 |
Mailing Telephone | 5034133900 |
Mailing Fax Number | 5034133710 |
Enumeration Date | 2017-04-08 |
Last Update Date | 2019-04-04 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
201703454NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
2800 N VANCOUVER AVE STE 165 |
City | PORTLAND |
State | OR |
Zip Code | 97227-1644 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750516845 | Alison M Mcewing | Counselor | 2800 N Vancouver Ave Ste 165, Portland, OR 97227-1644 | 2009-05-19 |
1427604586 | Erin Joy Warren | Nurse Practitioner | 2800 N Vancouver Ave Ste 165, Portland, OR 97227-1644 | 2019-08-14 |
1922483296 | Jacob Wicks | Social Worker | 2800 N Vancouver Ave Ste 165, Portland, OR 97227-1644 | 2015-07-28 |
1780079350 | Laura Michelle Dart | Pediatrics | 2800 N Vancouver Ave Ste 165, Portland, OR 97227-1644 | 2015-04-01 |
1306258082 | Deanna Lynn Labianca | Pediatrics | 2800 N Vancouver Ave Ste 165, Portland, OR 97227-1644 | 2014-05-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508466574 | Jessica Michelle Simonetti | Psychologist | Portland Psychotherapy Clinic, Research and Training Ce, 3700 N Williams Ave, Portland, OR 97227 | 2020-10-29 |
1447812268 | Maksim Yefimov | Physician Assistant | 2800 N Vancouver Ave Ste 130, Portland, OR 97227 | 2019-07-01 |
1851955975 | Erin Marie Staples | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave;, Suite 230, Portland, OR 97227 | 2019-04-24 |
1922588508 | Melanie Grace Mix | Physician Assistant | 501 N Graham St Ste 420, Portland, OR 97227 | 2018-08-14 |
1730615071 | Mehran Giblin | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave, Suite 230, Legacy Clinic Emanuel, Portland, OR 97227 | 2017-05-05 |
1730623687 | Christina Grace Belter | Optometrist | 300 N Graham St Ste 300, Portland, OR 97227 | 2016-12-12 |
1407300205 | Jenna Abernathy | Counselor | 3537 N Williams Ave, Portland, OR 97227 | 2016-08-09 |
1215390760 | Tanya Marie Woods | Massage Therapist | 3808 N. Williams Ave., Portland, OR 97227 | 2016-04-01 |
1033596853 | Eric Allen Martin | Counselor | 2054 N. Vancouver Ave, Portland, OR 97227 | 2015-04-30 |
1285040436 | Berk Neurosurgical LLC | Neurological Surgery | 501 N Graham St Ste 500, Portland, OR 97227 | 2014-07-09 |
Find all providers in zip 97227 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043822794 | Danielle Langer | Nurse Practitioner | 35 Ridgeview Rd, Portland, CT 06480-4014 | 2020-08-23 |
1508476250 | Harrington Health Clinic | Nurse Practitioner | 310 Nw Glisan Street, Portland, OR 97209 | 2020-08-07 |
1114566650 | Sadie Garnache-poirier | Nurse Practitioner | 65 W Commercial St Ste 107, Portland, ME 04101-4789 | 2020-01-02 |
1902441629 | Jennifer Marie Colpitts | Nurse Practitioner | 1600 Congress St Ste B, Portland, ME 04102-2148 | 2019-11-18 |
1477102689 | Raquel A Bishop | Nurse Practitioner | 12400 Nw Cornell Rd Ste 100, Portland, OR 97229 | 2019-09-10 |
1265081640 | Christina Lee | Nurse Practitioner | 144 State St # 1, Portland, ME 04101-3776 | 2019-09-09 |
1407401474 | Abby Christine Vopal | Nurse Practitioner | 66 Bramhall St Fl 1, Portland, ME 04102-3355 | 2019-08-07 |
1770145294 | Cynthia Marie Martinez | Nurse Practitioner | 1145 Austin St, Portland, TX 78374-2013 | 2019-07-04 |
1528532306 | Matthew James Keelin | Nurse Practitioner | 6801 Ne Cornfoot Rd, Portland, OR 97218-2743 | 2019-01-15 |
1659847580 | Colleen Jeanette Scott | Nurse Practitioner | 650 Nw Irving St, Portland, OR 97209-1272 | 2018-10-18 |
Find all providers in PORTLAND |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.