Provider Demographics
NPI:1225519671
Name:CIESLAK, CHELSEA M (DNP, NNP-BC)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:M
Last Name:CIESLAK
Suffix:
Gender:F
Credentials:DNP, NNP-BC
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:M
Other - Last Name:ROLINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2653 W WALTON ST APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-8283
Mailing Address - Country:US
Mailing Address - Phone:630-460-4645
Mailing Address - Fax:
Practice Address - Street 1:2801 N GANTENBEIN AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1623
Practice Address - Country:US
Practice Address - Phone:503-276-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201807163NP-PP363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal