Individual provider Active NPI

Diane Vines, PH.D., R.N.,

  • Psychiatric/Mental Health Registered Nurse
  • Portland, OR
National Provider Identifier
1053643775
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
200140577RN Issued in OR
Practice address
3880 SE 8TH Ave
Suite 110
Portland, OR 97202-3772
Phone
(503) 819-4285
NPI assigned
Feb 4, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 200140577RN OR Primary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X 198331 CA

Addresses

Primary practice location

3880 SE 8TH Ave
Suite 110
Portland, OR 97202-3772

Mailing address

3880 SE 8TH Ave
Suite 110
Portland, OR 97202-3772
Phone (503) 819-4285

Other identifiers 2

IdentifierTypeStateIssuer
200140577RNOtherORR.N. LICENSE
198331OtherCAR.N. LICENSE AND PSYCH NURSE PRACTITIONER INACTIVE

Other names 1

  • Diane Hawkins Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy, Registered Nurse

State licenses

LicenseStateTypeSpecialty
200140577RNORMDPsychiatric/Mental Health Registered Nurse
198331CAMDPsychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1265241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265241600000",
    "number": "1053643775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 SE 8TH AVE",
            "address_2": "SUITE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023772",
            "telephone_number": "503-819-4285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 SE 8TH AVE",
            "address_2": "SUITE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023772",
            "telephone_number": "503-819-4285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINES",
        "first_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "PH.D., R.N.,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-04",
        "last_updated": "2010-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": "200140577RN",
            "primary": true
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "CA",
            "license": "198331",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R.N. LICENSE",
            "identifier": "200140577RN",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R.N. LICENSE AND PSYCH NURSE PRACTITIONER INACTIVE",
            "identifier": "198331",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "HAWKINS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 4, 2010; 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.