Provider Demographics
NPI:1811052269
Name:ASHLEY, NANCY (CADC III)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:CADC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38872 PROCTOR BLVD
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:OR
Mailing Address - Zip Code:97055-8035
Mailing Address - Country:US
Mailing Address - Phone:503-722-6950
Mailing Address - Fax:503-722-6939
Practice Address - Street 1:38872 PROCTOR BLVD
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055-8035
Practice Address - Country:US
Practice Address - Phone:503-722-6950
Practice Address - Fax:503-722-6939
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR96-04-74101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR96-04-74OtherCADCIII