Healthcare Provider Details

I. General information

NPI: 1902424849
Provider Name (Legal Business Name): ALISON KATIE NASTOS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2020
Last Update Date: 07/07/2020
Certification Date: 07/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8716 E MILL PLAIN BLVD
VANCOUVER WA
98664-2531
US

IV. Provider business mailing address

505 SW CHESTNUT ST
PORTLAND OR
97219-2240
US

V. Phone/Fax

Practice location:
  • Phone: 360-514-4325
  • Fax:
Mailing address:
  • Phone: 503-267-1298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX1500X
TaxonomyOstomy Care Registered Nurse
License NumberRN60166604
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number200941571RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: