Healthcare Provider Details

I. General information

NPI: 1427223585
Provider Name (Legal Business Name): DEBORAH CAROL MESSECAR PHD MPH RN CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 04/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3455 SW VETERANS HOSPITAL RD OHSU MAIL CODE SN-4S
PORTLAND OR
97239-2941
US

IV. Provider business mailing address

3455 SW VETERANS HOSPITAL ROAD OHSU MAIL CODE SN-4S
PORTLAND OR
97239-2941
US

V. Phone/Fax

Practice location:
  • Phone: 503-494-3573
  • Fax: 503-494-4678
Mailing address:
  • Phone: 503-494-3573
  • Fax: 503-494-4678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number200170031CNS
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number079043009RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: