PROVIDENCE PORTLAND MEDICAL CENTER (NPI# 1316199987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316199987 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE PORTLAND MEDICAL CENTER |
| Other Organization Name | PROV NURSE PRACTITIONERS EAST |
| Practice Address |
4805 Ne Glisan St Portland OR 97213-2933 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5032156185 |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2011-10-11 |
| Authorized Official Name | WILLIAM OLSON (ADMINISTRATOR) |
| Authorized Official Telephone | 5032157384 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| PROV NURSE PRACTITIONERS EAST | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427258490 | Providence Portland Medical Center | Clinic/Center | 6241 Se Alder St, Portland, OR 97215-1971 | 2007-07-18 |
| 1134355985 | Providence Portland Medical Center | Clinic/Center | 4805 Ne Glisan St, 1st Floor, Portland, OR 97213-2933 | 2009-06-08 |
| 1134240021 | Providence Portland Medical Center | Clinic/Center | 4805 Ne Glisan St, Suite Bg05, Portland, OR 97213-2933 | 2007-04-02 |
| 1891861605 | Providence Portland Medical Center | Clinic/Center | 5050 Ne Hoyt St, Suite 155, Portland, OR 97213-2991 | 2006-11-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PROVIDENCE PORTLAND MEDICAL CENTER | 4805 Ne Glisan St, Portland, OR 97213-2933 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE PORTLAND MEDICAL CENTER | 4805 Ne Glisan St, Portland, OR 97213 |
| Street Address |
4805 NE GLISAN ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97213-2933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255337572 | John F Zurasky | Psychiatry & Neurology | 4805 Ne Glisan St, Ste 3g37, Portland, OR 97213-2933 | 2005-06-22 |
| 1083228175 | Alysia M Paaluhi | Registered Nurse | 4805 Ne Glisan St, Portland, OR 97213-2933 | 2020-09-04 |
| 1619595964 | Kathleen Hahn | Dietitian, Registered | 4805 Ne Glisan St, Portland, OR 97213-2933 | 2020-07-13 |
| 1841839107 | Daniel Dean Rosema | Nurse Practitioner | 4805 Ne Glisan St, Portland, OR 97213-2933 | 2020-01-03 |
| 1588207666 | Jean Hannon Mullins-padgett | Nurse Practitioner | 4805 Ne Glisan St, Portland, OR 97213-2933 | 2019-10-22 |
| 1043853146 | Miranda Meyer | Dietitian, Registered | 4805 Ne Glisan St, Portland, OR 97213-2933 | 2019-10-21 |
| 1083260830 | Becky L Bowler | Nurse Practitioner | 4805 Ne Glisan St, Portland, OR 97213-2933 | 2019-08-16 |
| 1366096406 | Nicole W Engel | Registered Nurse | 4805 Ne Glisan St, Portland, OR 97213-2933 | 2019-07-26 |
| 1558924753 | Susan Lien | Nurse Practitioner | 4805 Ne Glisan St, Portland, OR 97213-2933 | 2019-04-15 |
| 1356809644 | Katheryne Zempel | Physical Therapist | 4805 Ne Glisan St, Portland, OR 97213-2933 | 2019-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831715176 | Darnell Jackie Strong | Social Worker | 435 Ne 78th Ave 'strong Counseling Services', Portland, OR 97213 | 2020-06-23 |
| 1336775907 | Redpoint Physical Therapy and Performance LLC | Physical Therapist | 4200 Ne Flanders St Unit B, Portland, OR 97213 | 2020-03-16 |
| 1801431218 | Denise Dorgan-miller | Occupational Therapy Assistant | Providence Elder Place, 4400 Ne Halsey Suite 200, Portland, OR 97213 | 2019-11-08 |
| 1619435617 | Aspiration of Character Counseling Services, LLC | Counselor | 4424 Ne Glisan St, The Li Wellness Building, Second Floor, Portland, OR 97213 | 2019-03-08 |
| 1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
| 1023507795 | Karissa Lynn Schwartz | Speech-Language Pathologist | Providence Portland Medical Center, 4805 Ne Glisan St, Portland, OR 97213 | 2018-05-08 |
| 1861944506 | James Livingston Taylor | Chiropractor | 5212 Ne Sacremento St., Portland, OR 97213 | 2016-10-28 |
| 1962958520 | Caitlin Turner | Massage Therapist | 4317 Ne Tillamook St., Portland, OR 97213 | 2016-09-01 |
| 1326407008 | Julianna Vermeys | Counselor | 4605 Ne Fremont St., 209a, Portland, OR 97213 | 2016-02-23 |
| 1881059822 | Thomas Michael Barrett | Counselor | 5228 Ne Hoyt St. Bldg. B, Portland, OR 97213 | 2015-12-17 |
| Find all providers in zip 97213 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306450655 | Jocylin Egan | Nurse Practitioner | 442 Congress Street, 2nd Floor, Portland, ME 04101 | 2020-09-03 |
| 1427537844 | Mardin Sabah Sabir | Nurse Practitioner | 5050 Ne Hoyt St Ste 259, Portland, OR 97213-2984 | 2018-08-07 |
| 1174039325 | Gina Nicole Dasilva | Nurse Practitioner | 50 County Way, Portland, ME 04102-2755 | 2017-12-26 |
| 1609396746 | Maggie Michele Sexton | Nurse Practitioner | 2311 Nw Northrup St Ste 100, Portland, OR 97210-2912 | 2017-06-20 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1134585268 | Kathleen Klunk | Nurse Practitioner | 1400 Ne Alberta St, Portland, OR 97211-5044 | 2016-01-05 |
| 1427447143 | At Home Primary Care LLC. | Nurse Practitioner | 6400 Se Lake Rd # 420, Portland, OR 97222-2129 | 2015-01-19 |
| 1053753921 | Frederick Donald Watters | Nurse Practitioner | 66 Sherman St Apt 3, Portland, ME 04101 | 2013-07-22 |
| 1881033439 | Nicole M Baxter | Nurse Practitioner | 2187 Sw Main St Ste 101, Portland, OR 97205-1123 | 2013-06-17 |
| 1780937607 | Erika Kristine De La Garza | Nurse Practitioner | 1702 Hwy. 181 North, Portland, TX 78374 | 2012-10-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.