Provider Demographics
NPI:1588251532
Name:ANSEL, CAITLIN CONNOR (FNP)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:CONNOR
Last Name:ANSEL
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:CONNOR
Other - Last Name:MCDONNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3158
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3158
Mailing Address - Country:US
Mailing Address - Phone:503-215-6494
Mailing Address - Fax:
Practice Address - Street 1:1003 N PROVIDENCE DR STE 210
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-7523
Practice Address - Country:US
Practice Address - Phone:503-537-5620
Practice Address - Fax:971-282-0099
Is Sole Proprietor?:No
Enumeration Date:2020-12-23
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202008133NP-PP363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily