Provider Demographics
NPI:1053779801
Name:SEARLES, TASHA NICOLE (CNS)
Entity type:Individual
Prefix:
First Name:TASHA
Middle Name:NICOLE
Last Name:SEARLES
Suffix:
Gender:X
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 SE TACOMA ST # 105
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-6639
Mailing Address - Country:US
Mailing Address - Phone:971-200-5226
Mailing Address - Fax:866-480-3345
Practice Address - Street 1:1327 SE TACOMA ST # 105
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-6639
Practice Address - Country:US
Practice Address - Phone:971-200-5226
Practice Address - Fax:866-480-3345
Is Sole Proprietor?:No
Enumeration Date:2016-02-08
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201600526CNS-PP364S00000X
WARN60678135163W00000X
OR201509298RN163W00000X
IN28197083A163W00000X
WAAP60678136364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No163W00000XNursing Service ProvidersRegistered Nurse