Provider Demographics
NPI:1629961651
Name:FLESHMAN, NATHANIEL DEAN
Entity type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:DEAN
Last Name:FLESHMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1456 AVERY DR NE
Mailing Address - Street 2:
Mailing Address - City:SILVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97381-8753
Mailing Address - Country:US
Mailing Address - Phone:503-871-2915
Mailing Address - Fax:
Practice Address - Street 1:342 FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381-1917
Practice Address - Country:US
Practice Address - Phone:503-871-2915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-29
Last Update Date:2025-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201805845RN163W00000X
OR10045450367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse