Provider Demographics
NPI:1306900741
Name:OWENS, TRISHA KIE (RN)
Entity type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:KIE
Last Name:OWENS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:TRISHA
Other - Middle Name:KIE
Other - Last Name:OWENS-FERNANDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:261 SW WASHINGTON ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DALLAS
Mailing Address - State:OR
Mailing Address - Zip Code:97338-3423
Mailing Address - Country:US
Mailing Address - Phone:503-623-7889
Mailing Address - Fax:503-831-5202
Practice Address - Street 1:3180 CENTER ST NE
Practice Address - Street 2:DRUG TREATMENT
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4532
Practice Address - Country:US
Practice Address - Phone:503-588-5358
Practice Address - Fax:503-361-2688
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health