Provider Demographics
NPI:1871387621
Name:MOHAMED, NASTEHA AHMED
Entity type:Individual
Prefix:
First Name:NASTEHA
Middle Name:AHMED
Last Name:MOHAMED
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 NE STUCKI AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97006-8041
Mailing Address - Country:US
Mailing Address - Phone:541-975-3868
Mailing Address - Fax:
Practice Address - Street 1:1915 NE STUCKI AVE STE 305
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97006-8041
Practice Address - Country:US
Practice Address - Phone:541-975-3868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR10912101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor