NPIMap

Organization Active NPI

Northwest IV, LLC

Doing business as Evolve Health

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1023596541
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201392160NP-PP Issued in OR
Legal business name
NORTHWEST IV, LLC
Doing business as
Evolve Health
Practice address
6400 SE Lake Rd Ste 155
Portland, OR 97222-2137
Phone
(503) 447-3285
Fax
(503) 917-4971
NPI assigned
Aug 6, 2018
Last updated
Feb 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John Perry
Title
Managing Director
Phone
(503) 447-3285

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Family Nurse Practitioner 363LF0000X 201392160NP-PP OR Primary
Anesthesiology Physician 207L00000X MD22534 OR

Addresses

Primary practice location

6400 SE Lake Rd Ste 155
Portland, OR 97222-2137

Mailing address

6400 SE Lake Rd Ste 155
Portland, OR 97222-2137
Phone (503) 447-3285

Other names 1

  • Evolve Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190327002802 OR Part B Supplier - Clinic/Group Practice 7214277383 Receives reassigned benefits from 13 practitioners
2 other NPIs on this enrollment
Practice locations: Beaverton, OR; Bend, OR; Portland, OR

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Northwest IV LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

16100 NW Cornell Rd
Ste 190
Beaverton, OR 97006
Phone (888) 830-6088

6400 SE Lake Rd
Ste 142
Portland, OR 97222
Phone 9713589292210

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770249600000",
    "number": "1023596541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 SE LAKE RD STE 155",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972222137",
            "telephone_number": "503-447-3285",
            "fax_number": "503-917-4971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 SE LAKE RD STE 155",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972222137",
            "telephone_number": "503-447-3285",
            "fax_number": "503-917-4971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST IV, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-06",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "503-447-3285"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201392160NP-PP",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD22534",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evolve Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.