Provider Demographics
NPI:1811436587
Name:ANASTASIO, ASHLEY MARIE (LPN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:ANASTASIO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:MARIE
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2035 DAVCOR ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-1595
Mailing Address - Country:US
Mailing Address - Phone:503-576-4660
Mailing Address - Fax:503-361-2688
Practice Address - Street 1:2035 DAVCOR ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-1595
Practice Address - Country:US
Practice Address - Phone:503-576-4660
Practice Address - Fax:503-361-2688
Is Sole Proprietor?:No
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201502856LPN164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse