MR. SAMUEL JOSEPH CROSS-SARVIS PMHNP-BC FNP-C NPI 1922305978

NPI Information

NPI: 1922305978
Provider Name: MR. SAMUEL JOSEPH CROSS-SARVIS, PMHNP-BC, FNP-C
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
5263 NE MARTIN LUTHER KING JR BLVD
PORTLAND, OR
ZIP 97211
Phone: (503) 217-4455
Get Directions

MR. Samuel Joseph Cross-sarvis, PMHNP-BC, FNP-C is a psychiatric/mental health nurse practitioner in Portland, OR. MR. Samuel Joseph Cross-sarvis, PMHNP-BC, FNP-C NPI is 1922305978. 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:

5263 NE MARTIN LUTHER KING JR BLVD
PORTLAND, OR
ZIP 97211-235
Phone: (503) 217-4455

The NPI 1922305978 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/25/2011 and was last updated on 7/19/2021.

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
1	163W00000X	Registered Nurse		RN00176573	WASHINGTON	No
2	363LF0000X	Nurse Practitioner	Family	95003416	CALIFORNIA	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	201707205NP-PP	OREGON	Yes
4	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	60621382	WASHINGTON	No

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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