Provider Demographics
NPI:1457622805
Name:OSGOOD, CANDACE RENE (PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CANDACE
Middle Name:RENE
Last Name:OSGOOD
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 W ORCHARD AVE
Mailing Address - Street 2:STE A
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-1592
Mailing Address - Country:US
Mailing Address - Phone:541-289-1637
Mailing Address - Fax:541-567-2552
Practice Address - Street 1:955 W ORCHARD AVE STE A
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-1592
Practice Address - Country:US
Practice Address - Phone:541-289-1637
Practice Address - Fax:541-567-2552
Is Sole Proprietor?:No
Enumeration Date:2012-01-17
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201250006NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health