Provider Demographics
NPI:1598951501
Name:STELL, CASSANDRA (PMHNP)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:
Last Name:STELL
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:MISS
Other - First Name:CASSANDRA
Other - Middle Name:
Other - Last Name:WHITTINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:2250 NW FLANDERS ST STE 105
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-5409
Mailing Address - Country:US
Mailing Address - Phone:503-238-0769
Mailing Address - Fax:
Practice Address - Street 1:2250 NW FLANDERS ST STE 105
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-5409
Practice Address - Country:US
Practice Address - Phone:503-444-8440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR096000176RN163WG0000X, 163WP0808X
OR200850054363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty