Provider Demographics
NPI:1417502162
Name:STRASSER, MISTY R (PMHNP)
Entity Type:Individual
Prefix:
First Name:MISTY
Middle Name:R
Last Name:STRASSER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:MISTY
Other - Middle Name:R
Other - Last Name:SCHRINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:875 NW RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MILL CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97360-2108
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2600 CENTER ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-2669
Practice Address - Country:US
Practice Address - Phone:503-945-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201906639NP-PP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health