Provider Demographics
NPI:1043517188
Name:DEMSKY, PATRICIA A (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:DEMSKY
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:A
Other - Last Name:STIRLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2005 NW MCGAREY DR
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-6773
Mailing Address - Country:US
Mailing Address - Phone:734-223-6766
Mailing Address - Fax:
Practice Address - Street 1:10700 SW BEAVERTON HILLSDALE HWY
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3019
Practice Address - Country:US
Practice Address - Phone:248-652-5291
Practice Address - Fax:248-652-5817
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-25
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704130153363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP39330080Medicare UPIN