Provider Demographics
NPI:1285457366
Name:MASSARI, ASHLEY (BSN, RNC-NIC, CNPT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:MASSARI
Suffix:
Gender:F
Credentials:BSN, RNC-NIC, CNPT
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:ARSCHEENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3540 SE 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-2630
Mailing Address - Country:US
Mailing Address - Phone:586-524-9149
Mailing Address - Fax:
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3098
Practice Address - Country:US
Practice Address - Phone:503-494-8311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202209143RN163WN0002X, 163WP0200X, 163WF0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WF0300XNursing Service ProvidersRegistered NurseFlight
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care
No163WP0200XNursing Service ProvidersRegistered NursePediatricsGroup - Multi-Specialty