Provider Demographics
NPI:1962767459
Name:TRUE NORTH PSYCHIATRIC SOLUTIONS
Entity type:Organization
Organization Name:TRUE NORTH PSYCHIATRIC SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:R
Authorized Official - Last Name:OSGOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:541-289-1637
Mailing Address - Street 1:955 W ORCHARD AVE STE A
Mailing Address - Street 2:
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-1592
Mailing Address - Country:US
Mailing Address - Phone:541-289-1637
Mailing Address - Fax:541-567-2552
Practice Address - Street 1:955 W ORCHARD AVE STE A
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-1592
Practice Address - Country:US
Practice Address - Phone:541-289-1637
Practice Address - Fax:541-567-2552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-10
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201250006NP363LP0808X
WAAP600279781363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR165907Medicare UPIN