Provider Demographics
NPI:1831278274
Name:AHERN, CATHLEEN MARIE (PMHNP)
Entity type:Individual
Prefix:MS
First Name:CATHLEEN
Middle Name:MARIE
Last Name:AHERN
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 1:8383 NE SANDY BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-4948
Mailing Address - Country:US
Mailing Address - Phone:503-253-0964
Mailing Address - Fax:503-253-7659
Practice Address - Street 1:8383 NE SANDY BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-4948
Practice Address - Country:US
Practice Address - Phone:503-253-0964
Practice Address - Fax:503-253-7659
Is Sole Proprietor?:No
Enumeration Date:2006-11-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163W00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORMA0705472OtherDEA NUMBER