Healthcare Provider Details

I. General information

NPI: 1639081847
Provider Name (Legal Business Name): CASSANDRA PARMENTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1874 CABEZON CT
NORTH BEND OR
97459-1831
US

IV. Provider business mailing address

1874 CABEZON CT
NORTH BEND OR
97459-1831
US

V. Phone/Fax

Practice location:
  • Phone: 541-297-4147
  • Fax:
Mailing address:
  • Phone: 541-297-4147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number099000579
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: