Active NPI
Cassandre Piersol, ANP-BC
- Adult Health Nurse Practitioner
- Tualatin, OR
National Provider Identifier
1407141765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 201606106NP-PP
- Practice address
- 19250 SW 90TH Ave
Tualatin, OR 97062 - Phone
- (503) 692-3750
- Fax
- (503) 691-2324
- NPI assigned
- Jun 15, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 19961 | CA | |
| Adult Health Nurse Practitioner | 363LA2200X | 201606106NP-PP | OR | Primary |
Addresses
Primary practice location
19250 SW 90TH Ave
Tualatin, OR 97062
Mailing address
847 NE 19TH Ave Ste 300
Portland, OR 97232-2686
Phone (503) 963-2801
Other practice location 1
3801 Miranda Ave
Palo Alto, CA 94304-1207
Phone (650) 493-5000
Other practice location 2
19250 SW 90th Ave
Tualatin, OR 97062
Phone (503) 692-3750
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500767601 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19961 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567987200000",
"number": "1407141765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "847 NE 19TH AVE STE 300",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972322686",
"telephone_number": "503-963-2801",
"fax_number": "503-963-2825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19250 SW 90TH AVE",
"city": "TUALATIN",
"state": "OR",
"postal_code": "97062",
"telephone_number": "503-692-3750",
"fax_number": "503-691-2324"
}
],
"practiceLocations": [
{
"address_1": "3801 Miranda Ave",
"address_purpose": "LOCATION",
"city": "Palo Alto",
"state": "CA",
"postal_code": "943041207",
"country_code": "US",
"telephone_number": "650-493-5000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "19250 SW 90th Ave",
"address_purpose": "LOCATION",
"city": "Tualatin",
"state": "OR",
"postal_code": "97062",
"country_code": "US",
"telephone_number": "503-692-3750",
"fax_number": "503-691-2324",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PIERSOL",
"first_name": "CASSANDRE",
"credential": "ANP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-15",
"last_updated": "2019-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "CA",
"license": "19961",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "OR",
"license": "201606106NP-PP",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500767601",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tualatin, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.