MR. JACOB CREVISTON MN RN PMHNP-BC NPI 1528460813

NPI Information

NPI: 1528460813
Provider Name: MR. JACOB CREVISTON, MN, RN, PMHNP-BC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Address:
314 NE 19TH AVE
PORTLAND, OR
ZIP 97232
Phone: (503) 239-8181
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MR. Jacob Creviston, MN, RN, PMHNP-BC is a psychiatric/mental health nurse practitioner in Portland, OR. MR. Jacob Creviston, MN, RN, PMHNP-BC NPI is 1528460813. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

314 NE 19TH AVE
PORTLAND, OR
ZIP 97232-829
Phone: (503) 239-8181

The enumeration date for this NPI number is 9/18/2014 and was last updated on 10/24/2014.

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
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	201405518NP-PP	OREGON	Yes

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: 4/28/2024

NPI Synchronization or Removal

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