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General NPI Number Information
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NPI Number | 1598538241
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Entity Type | Individual
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Provider Name | SYDNEY HANNA FANNING PMHNP
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Gender | Female
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Dates
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Enumeration Date | 11/03/2023
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 10300 SW EASTRIDGE ST.
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City | PORTLAND
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State | OR
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Zip | 97225
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Country | US
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Telephone | 503-944-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 11537 SW COLLINA LANE
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City | WILSONVILLE
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State | OR
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Zip | 97070
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Country | US
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Telephone | 503-860-7812
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 10018078
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License Number State | OR
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