Provider Demographics
NPI:1366970758
Name:ACCUARDI, TRISTIN MARIE (NP)
Entity type:Individual
Prefix:
First Name:TRISTIN
Middle Name:MARIE
Last Name:ACCUARDI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TRISTIN
Other - Middle Name:MARIE
Other - Last Name:BROWNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2111 EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-3329
Mailing Address - Country:US
Mailing Address - Phone:503-325-4321
Mailing Address - Fax:
Practice Address - Street 1:2265 EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-3331
Practice Address - Country:US
Practice Address - Phone:503-338-4050
Practice Address - Fax:503-338-4051
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10013335363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner