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Individual

SANA GOLDBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BA, RN, PMHNP-BC

Contact information

Practice address
1002 SE 54TH AVE, PORTLAND, OR 97215-2654
(503) 386-0729
(503) 386-0729
Mailing address
1002 SE 54TH AVE, PORTLAND, OR 97215-2654
(971) 717-4866
(503) 386-0729

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201608009RN
OR
163W00000X
Registered Nurse
RN61111255
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
202006871NP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP61113620
WA

Other

Enumeration date
07/17/2020
Last updated
06/15/2021
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