Individual provider · Type 1 NPI

Stacy Vantighem

Medical-Surgical Registered Nurse · Portland, OR

NPI number 1558664979 Active

Practice location

3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964

Mailing address

5525 SW Ames Way
Portland, OR 97225-1003

Specialties and licenses

TaxonomyCodeLicense
Medical-Surgical Registered Nurse Primary 163WM0705X201041174RN (OR)
Medical-Surgical Registered Nurse 163WM0705X28373 (MT)

Medical-Surgical Registered Nurse: Definition to come...

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About NPI 1558664979

Stacy Vantighem's National Provider Identifier is 1558664979, issued on Dec 7, 2010. The primary taxonomy on file is Medical-Surgical Registered Nurse (163WM0705X), and the practice location is in Portland, OR. The record was last updated on Dec 7, 2010.