Healthcare Provider Details

I. General information

NPI: 1568958635
Provider Name (Legal Business Name): TASHA UFUOMA OLADIPO PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2018
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 W SPERRY STREET
HEPPNER OR
97836
US

IV. Provider business mailing address

5510 PERSIMMON PASS
RICHMOND TX
77407-4045
US

V. Phone/Fax

Practice location:
  • Phone: 541-676-9161
  • Fax: 541-676-5662
Mailing address:
  • Phone: 713-922-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61237372
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number6350
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberMO9644685
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP137694
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number405375
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberMO7111139
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: