Healthcare Provider Details

I. General information

NPI: 1912949926
Provider Name (Legal Business Name): MEGAN JAYE SORENSEN DNP, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 NW 9TH ST
CORVALLIS OR
97330-3857
US

IV. Provider business mailing address

2727 NW 9TH ST
CORVALLIS OR
97330-3857
US

V. Phone/Fax

Practice location:
  • Phone: 503-269-3610
  • Fax: 541-735-9463
Mailing address:
  • Phone: 503-269-3610
  • Fax: 541-735-9463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License NumberR172938-0
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number201604311CNS-PP
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License Number201604311CNS-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: