Provider Demographics
NPI:1689184814
Name:SARASWATI, SIWI S (DNP-FNP)
Entity Type:Individual
Prefix:
First Name:SIWI
Middle Name:S
Last Name:SARASWATI
Suffix:
Gender:F
Credentials:DNP-FNP
Other - Prefix:
Other - First Name:SIWI
Other - Middle Name:S
Other - Last Name:TOH-DJOJO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10180 SE SUNNYSIDE RD
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-8970
Mailing Address - Country:US
Mailing Address - Phone:888-813-2100
Mailing Address - Fax:
Practice Address - Street 1:10180 SE SUNNYSIDE RD
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-8970
Practice Address - Country:US
Practice Address - Phone:888-813-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-02
Last Update Date:2023-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202212153NP-PP363L00000X
OR201504987163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR201504987RNOtherCLINICAL FOR FAMILY NURSE PRACTITIONER