Individual
ANA TATTERSALL-COCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC, CNS-BC
Contact information
Practice address
1500 NE IRVING ST STE 210, PORTLAND, OR 97232-2243
(971) 365-3166
(210) 210-7615
Mailing address
11740 SW 68TH PKWY STE 200, PORTLAND, OR 97223-9058
(971) 365-3166
(971) 352-6984
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP109816
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10023633
OR
364S00000X
Clinical Nurse Specialist
AP109816
TX
364SA2200X
Adult Health Clinical Nurse Specialist
AP109816
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153807601
—
TX
05
—
153807604
—
TX
01
—
153807605
CSHCN
TX
01
—
344932
AACC-ACNS-BS
TX
Enumeration date
05/16/2006
Last updated
03/10/2026
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