IndividualActive
Darya Balanetskaya, ACPCNP
NPI 1457012791 · Gerontology Nurse Practitioner · Portland, OR
Provider details
- NPI number
- 1457012791
- Entity type
- Individual
- Primary specialty
- Gerontology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- ACPCNP
- Sex
- Female
- Sole proprietor
- No
- License
- 202206690NP-PP (OR)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Nursing Service Providers
Practice location
17727 E Burnside St
Portland, OR 97233-4803
Phone: (503) 215-9800
Approximate (ZIP-level) locationGet directions
Mailing address
17727 E Burnside St
Portland, OR 97233-4803
Registry dates
- Enumerated
- 2022-01-08
- Last updated
- 2024-10-25
- Certified
- 2024-10-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.