Provider Demographics
NPI:1881228849
Name:ANDRADE, DAMARIS (PMHNP)
Entity Type:Individual
Prefix:
First Name:DAMARIS
Middle Name:
Last Name:ANDRADE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E MAIN ST STE 212
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4173
Mailing Address - Country:US
Mailing Address - Phone:503-549-4010
Mailing Address - Fax:
Practice Address - Street 1:315 E MAIN ST STE 212
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4173
Practice Address - Country:US
Practice Address - Phone:503-549-4010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-28
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202202152NP-PP163WP0808X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health