Healthcare Provider Details

I. General information

NPI: 1265458905
Provider Name (Legal Business Name): CHRISTOPHER MCCARTHY SILVA FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 05/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 MONMOUTH AVE N
MONMOUTH OR
97361-1329
US

IV. Provider business mailing address

13705 NE 43RD CT
VANCOUVER WA
98686-2640
US

V. Phone/Fax

Practice location:
  • Phone: 503-838-8313
  • Fax:
Mailing address:
  • Phone: 207-756-0654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR042339
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0473272303
License Number StateNH
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201250120NP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: