Individual
MRS. MICHELLE DAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC, MSN,MA, RN
Contact information
Practice address
3939 NE HANCOCK ST STE 218, PORTLAND, OR 97212-5321
(503) 782-1963
(503) 987-5977
Mailing address
3939 NE HANCOCK ST STE 218, PORTLAND, OR 97212-5321
(503) 782-1963
(503) 987-5977
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
14474
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201506948NP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP61070949
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500694332
—
OR
Enumeration date
10/23/2009
Last updated
02/01/2023
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