Provider Demographics
NPI:1417203605
Name:ASH, KRISTEN A (ANP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:A
Last Name:ASH
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3181 SW SAM JACKSON PARK RD # BTE119
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3098
Mailing Address - Country:US
Mailing Address - Phone:503-494-6101
Mailing Address - Fax:
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD # BTE119
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3098
Practice Address - Country:US
Practice Address - Phone:503-494-6101
Practice Address - Fax:503-494-1159
Is Sole Proprietor?:No
Enumeration Date:2012-07-25
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201394459NP-PP363LA2200X
OR201042402RN163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine