Provider Demographics
NPI:1790860765
Name:DAMASKOS, LINDA SUE (CRNFA)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:SUE
Last Name:DAMASKOS
Suffix:
Gender:F
Credentials:CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:847 NE 19TH AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2684
Mailing Address - Country:US
Mailing Address - Phone:503-963-2801
Mailing Address - Fax:503-963-2825
Practice Address - Street 1:5050 NE HOYT ST
Practice Address - Street 2:SUITE 651
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2991
Practice Address - Country:US
Practice Address - Phone:503-297-3766
Practice Address - Fax:503-297-8148
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00057558163WR0006X
OR201041344RN163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA41161OtherL & I
WADA0057OtherREGENCE
WA9611070Medicaid
OR500672410Medicaid
WA5723OtherGROUP HEALTH
WA5723OtherGROUP HEALTH