Nathan Fasold

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

200842345RN Issued in OR

Practice address

5029 NE Killingsworth St
Portland, OR 97218

Phone

(503) 402-8117

NPI assigned

Apr 1, 2009

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289779200000",
    "number": "1528200847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8459",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972078459",
            "telephone_number": "503-238-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5029 NE KILLINGSWORTH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97218",
            "telephone_number": "503-402-8117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASOLD",
        "first_name": "NATHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-01",
        "last_updated": "2010-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": "200842345RN",
            "primary": true
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyline Nicole Farwell, PA
• Ryan M Farwell, OT
• Halley Farwood, PSYD
• Farzad Pirayesh, DMD, P.C.
• Clara Cedarblade Fashana, N.D, L.AC
• Nicole Marie Fassiotto
• Jayme Leigh Fast
• Jay Fasteen, PTA
• Jennifer Mary Fasulo, RN
• Jerrica Fasy

• Psychiatric/Mental Health Registered Nurse in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatric/Mental Health Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.