Provider Demographics
NPI:1760849780
Name:PRESTON, SASHA MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:SASHA
Middle Name:MARIE
Last Name:PRESTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SASHA
Other - Middle Name:
Other - Last Name:MIHANKHAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:12442 SW SCHOLLS FERRY RD STE 206
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-0804
Mailing Address - Country:US
Mailing Address - Phone:503-216-9200
Mailing Address - Fax:503-216-9130
Practice Address - Street 1:12442 SW SCHOLLS FERRY RD STE 206
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-0804
Practice Address - Country:US
Practice Address - Phone:503-216-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28195069A163W00000X
OR201508550RN163W00000X
OR201604519NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse