Organization Active NPI

Fibromyalgia Focus, Inc

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1053779488
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
200150080 Issued in OR
Legal business name
FIBROMYALGIA FOCUS, INC
Practice address
1675 SW Marlow Ave
Suite 210B
Portland, OR 97225-5104
Phone
(503) 389-3106
Fax
(503) 546-4223
NPI assigned
Jan 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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

Authorized official

Name
Mrs. Cheryl Ann Hryciw, MS, FNP
Title
Nurse Practitioner
Phone
(971) 344-8600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 200150080 OR Primary

Addresses

Primary practice location

1675 SW Marlow Ave
Suite 210B
Portland, OR 97225-5104

Mailing address

1675 SW Marlow Ave Ste 210B
Portland, OR 97225-5162
Phone (503) 389-3106

Other identifiers 1

IdentifierTypeStateIssuer
R180604OtherORMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

1675 SW Marlow Ave
Ste 210B
Portland, OR 97225
Phone (503) 389-3106

NPI Registry JSON

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

{
    "created_epoch": "1454112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1053779488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 SW MARLOW AVE STE 210B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255162",
            "telephone_number": "503-389-3106",
            "fax_number": "503-546-4223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 SW MARLOW AVE",
            "address_2": "SUITE 210B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255104",
            "telephone_number": "503-389-3106",
            "fax_number": "503-546-4223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIBROMYALGIA FOCUS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-30",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "HRYCIW",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "971-344-8600",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200150080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "R180604",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 13, 2017; 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.