Basic Information
Provider Information
NPI: 1639592231
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PISIGAN
FirstName: CHERRY
MiddleName: CLARISSA
NamePrefix: MS.
NameSuffix:  
Credential: DNP, FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2051 KAEN RD
Address2: SUITE 367
City: OREGON CITY
State: OR
PostalCode: 970454035
CountryCode: US
TelephoneNumber: 5037425300
FaxNumber: 5037425979
Practice Location
Address1: 1425 BEAVERCREEK RD
Address2:  
City: OREGON CITY
State: OR
PostalCode: 970454076
CountryCode: US
TelephoneNumber: 5036658471
FaxNumber: 5037234946
Other Information
ProviderEnumerationDate: 02/03/2014
LastUpdateDate: 10/18/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X201250174NPORY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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