Individual
SHARLYNN VAN TASSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP, PMHNP-BC
Contact information
Practice address
7515 FALCON CREST DR # 200, REDMOND, OR 97756-5014
(541) 904-5216
(541) 527-4347
Mailing address
5260 N MOOSE CREEK AVE, MERIDIAN, ID 83646-3643
(208) 308-5650
(208) 308-5650
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
20170195BNP-PP
OR
363LF0000X
Family Nurse Practitioner
26662
ID
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
201701958NP-PP
OR
Other
Enumeration date
09/26/2016
Last updated
07/20/2022
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