Elona Kassia Dellabough-Gormley

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10016533 Issued in OR

Practice address

727 W Burnside St
Portland, OR 97209-3514

Phone

(503) 228-4533

NPI assigned

May 29, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Elona Gormley Former name

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
• WA PPO C-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Central City Concern

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1881658276
  NPD (past)

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1023676640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 NW 6TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 W BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093514",
            "telephone_number": "503-228-4533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELLABOUGH-GORMLEY",
        "first_name": "ELONA",
        "middle_name": "KASSIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201600281RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10016533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELONA",
            "last_name": "GORMLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vincent Delisle-Todd
• Noah James Delisle, ATC, LAT
• Jennifer Dell
• Carol Ann Dell'Oliver, PH.D.
• Mark A Della Paolera, PHARMD, BCPS
• Karen Ann Dellinger, MD
• Michael Dean Dellinger, MD
• Peter John Delmar Jr., RN
• Lyn Ann Delmastro, M.A., R.Y.T.
• Daisy Delmore

• Family Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.