Healthcare Provider Details

I. General information

NPI: 1285457366
Provider Name (Legal Business Name): ASHLEY MASSARI BSN, RNC-NIC, CNPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ASHLEY ARSCHEENE

II. Dates (important events)

Enumeration Date: 11/06/2024
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3181 SW SAM JACKSON PARK RD
PORTLAND OR
97239-3098
US

IV. Provider business mailing address

3540 SE 67TH AVE
PORTLAND OR
97206-2630
US

V. Phone/Fax

Practice location:
  • Phone: 503-494-8311
  • Fax:
Mailing address:
  • Phone: 586-524-9149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number202209143RN
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number202209143RN
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code163WF0300X
TaxonomyFlight Registered Nurse
License Number202209143RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: