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General NPI Number Information
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NPI Number | 1861025256
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Entity Type | Individual
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Provider Name | TARA CANDELA APRN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/13/2020
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 1027 E BURNSIDE ST
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City | PORTLAND
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State | OR
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Zip | 97214-1328
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Country | US
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Telephone | 503-239-8400
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Fax | 503-239-8406
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Provider Business Mailing Address
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Address Line | 1975 NW 167TH PL STE 100-20
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City | BEAVERTON
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State | OR
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Zip | 97006-4908
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Country | US
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Telephone | 503-874-6463
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Fax | 503-831-8947
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 201609336RN
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | RN61084371
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP61144096
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 202101319NP-PP
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License Number State | OR
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