NPIMap

Organization Active NPI

Northwest Vitality Group

  • Clinic/Center
  • Portland, OR
National Provider Identifier
1033853783
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
NORTHWEST VITALITY GROUP
Doing business as
Northwest Vitality Group
Practice address
9233 SW 52ND Ave
Portland, OR 97219-5003
Phone
(503) 757-8535
Fax
(971) 223-0949
NPI assigned
Apr 27, 2022
Last updated
Apr 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Authorized official

Name
Dr. Holly Anne Fay, DNP, APRN, FNP-ANPI 1932756707
Title
Owner/Provider/Cmo
Phone
(503) 757-8535

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

9233 SW 52ND Ave
Portland, OR 97219-5003

Mailing address

3 Monrow Pkwy
Ste P #714
Lake Oswego, OR 97035
Phone (503) 477-5084

Other names 1

  • Northwest Vitality Group Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1651017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1033853783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MONROW PKWY",
            "address_2": "STE P #714",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "97035",
            "telephone_number": "503-477-5084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9233 SW 52ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972195003",
            "telephone_number": "503-757-8535",
            "fax_number": "971-223-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST VITALITY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-27",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-11",
        "status": "A",
        "authorized_official_last_name": "FAY",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER/PROVIDER/CMO",
        "authorized_official_telephone_number": "503-757-8535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, APRN, FNP-A"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Vitality Group",
            "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 Apr 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.