STASIS PSYCHIATRY LLC NPI 1427527886

NPI Information

  • NPI: 1427527886
  • Provider Name: STASIS PSYCHIATRY, LLC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Doing Business As: NATHAN JOHNSON, PMHNP
  • Address: 4035 12TH ST CUTOFF SE STE 120
    SALEM, OR
    ZIP 97302
  • Phone: (971) 304-9306

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NPI Details

STASIS PSYCHIATRY, LLC is a psychiatric/mental health nurse practitioner in Salem, OR. STASIS PSYCHIATRY, LLC NPI is 1427527886. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Nathan Johnson, Pmhnp.

The provider's business location address is:

4035 12TH ST CUTOFF SE STE 120
SALEM, OR
ZIP 97302-754
Phone: (971) 304-9306
Fax: (503) 926-6624

The provider's authorized official is Nathan Patrick Johnson .
The authorized official title is Owner and has the following contact phone number (971) 304-9306.

The enumeration date for this NPI number is 11/15/2018 and was last updated on 4/13/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084P0800XPsychiatry & NeurologyPsychiatryNo
2363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1500735377MEDICAIDTENNESSEE
21952754442OTHERTENNESSEENPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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