Healthcare Provider Details

I. General information

NPI: 1669270765
Provider Name (Legal Business Name): STASHA CHRISTIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 NE 3RD ST # 53
BEND OR
97701-4700
US

IV. Provider business mailing address

440 E BROADWAY STE 300
EUGENE OR
97401-3352
US

V. Phone/Fax

Practice location:
  • Phone: 541-241-6171
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number38051
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10041669
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: