Healthcare Provider Details

I. General information

NPI: 1952771008
Provider Name (Legal Business Name): DANIELLE MARIE HASTINGS PNP-CP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2015
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9290 SE SUNNYBROOK BLVD #200
CLACKAMAS OR
97015-6899
US

IV. Provider business mailing address

9290 SE SUNNYBROOK BLVD #200
CLACKAMAS OR
97015-6899
US

V. Phone/Fax

Practice location:
  • Phone: 503-659-1694
  • Fax:
Mailing address:
  • Phone: 503-659-1694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number116731-23
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number201507357NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: