Healthcare Provider Details

I. General information

NPI: 1821009606
Provider Name (Legal Business Name): SHARON J. HAMMOND PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHARYN J. HAMMOND PMHNP

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5251 NE GLISAN ST BLDG A, 2ND FLOOR
PORTLAND OR
97213-3052
US

IV. Provider business mailing address

PO BOX 3158
PORTLAND OR
97208-3158
US

V. Phone/Fax

Practice location:
  • Phone: 503-215-6285
  • Fax:
Mailing address:
  • Phone: 503-215-6494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number200650081NP
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number200650081NP
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number200650081NP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: