Individual
MS. KASEY MCCRACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
5331 S MACADAM AVE, STE 258 PMB 1063, PORTLAND, OR 97239-3871
(512) 964-8676
Mailing address
5331 S MACADAM AVE, STE 258 PMB 1063, PORTLAND, OR 97239-3871
(512) 964-8676
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201392675RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201507467NP-PP
OR
Other
Enumeration date
01/19/2016
Last updated
03/31/2025
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