Provider Demographics
NPI:1114381415
Name:AURISY, ALYSSA (RN, APRN, PMHNP)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:AURISY
Suffix:
Gender:F
Credentials:RN, APRN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15110 BOONES FERRY RD. STE. 248
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-3498
Mailing Address - Country:US
Mailing Address - Phone:503-741-2735
Mailing Address - Fax:503-308-7222
Practice Address - Street 1:15110 BOONES FERRY RD. STE. 248
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-3498
Practice Address - Country:US
Practice Address - Phone:503-741-2735
Practice Address - Fax:503-308-7222
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200741244RN163W00000X
OR10000147363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse