Active NPI
Craig Preston, R.N.
- Registered Nurse
- Gresham, OR
National Provider Identifier
1053644229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 200940688RN
- Practice address
- 4101 NE Division St Ste 100
Gresham, OR 97030-4617 - Phone
- (503) 666-3808
- NPI assigned
- Sep 4, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 200940688RN | OR | Primary |
Addresses
Primary practice location
4101 NE Division St Ste 100
Gresham, OR 97030-4617
Mailing address
1134 SE 60TH Ave
Portland, OR 97215-2805
Phone (503) 706-0172
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200940688RN | OR | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252022400000",
"number": "1053644229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1134 SE 60TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972152805",
"telephone_number": "503-706-0172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4101 NE DIVISION ST STE 100",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970304617",
"telephone_number": "503-666-3808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRESTON",
"first_name": "CRAIG",
"credential": "R.N.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-04",
"last_updated": "2009-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OR",
"license": "200940688RN",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.