Provider Demographics
NPI:1760260491
Name:SANTIAGO, STEPHANIE OLIVIA (RN, BSN, MSN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:OLIVIA
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:RN, BSN, MSN
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:OLIVIA
Other - Last Name:SERNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN, MSN
Mailing Address - Street 1:3455 SW US VETERANS HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3076
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3455 SW US VETERANS HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3076
Practice Address - Country:US
Practice Address - Phone:503-494-7725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program