Individual provider Active NPI

Dawn Mary Allen, NNP

  • Critical Care Neonatal Nurse Practitioner
  • Lake Oswego, OR
National Provider Identifier
1093836934
Registry record updated Mar 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
201050159NP Issued in OR
Practice address
17079 Cherry Crest Ave
Lake Oswego, OR 97034-5946
Phone
(209) 404-6765
NPI assigned
Apr 2, 2007
Last updated
Mar 27, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2014

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X 201050159NP OR Primary
Critical Care Neonatal Nurse Practitioner 363LN0005X AP30006316 WA
Critical Care Neonatal Nurse Practitioner 363LN0005X 12884 CA
Neonatal Clinical Nurse Specialist 364SN0000X 418590 CA
Neonatal Clinical Nurse Specialist 364SN0000X 200870015CNS OR

Addresses

Primary practice location

17079 Cherry Crest Ave
Lake Oswego, OR 97034-5946

Mailing address

17079 Cherry Crest Ave
Lake Oswego, OR 97034-5946
Phone (209) 404-6765

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110118000349 OR Practitioner - Nurse Practitioner 3072702372 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201050159NPORMDCritical Care Neonatal Nurse Practitioner
AP30006316WAMDCritical Care Neonatal Nurse Practitioner
418590CAMDNeonatal Clinical Nurse Specialist
200870015CNSORMDNeonatal Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Jun 1, 2014 Accepting new patients
Salem Health CurrentSince Nov 17, 2010 Accepting new patients
University Professional Services CurrentSince Jun 1, 2014 Accepting new patients
University Professional Services Current Accepting new patients
Salem Health CurrentSince Nov 17, 2010 Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

Interoperability endpoints

  • Direct secure messaging: dallen74470@direct.peacehealth.org

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395878400000",
    "number": "1093836934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17079 CHERRY CREST AVE",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970345946",
            "telephone_number": "209-404-6765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17079 CHERRY CREST AVE",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970345946",
            "telephone_number": "209-404-6765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "DAWN",
        "middle_name": "MARY",
        "credential": "NNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2014-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "OR",
            "license": "201050159NP",
            "primary": true
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "WA",
            "license": "AP30006316",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "CA",
            "license": "12884",
            "primary": false
        },
        {
            "code": "364SN0000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Neonatal",
            "state": "CA",
            "license": "418590",
            "primary": false
        },
        {
            "code": "364SN0000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Neonatal",
            "state": "OR",
            "license": "200870015CNS",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

Verify at the official NPI Registry.