Individual provider Active NPI

Keri Swanson, RN, CNOR, RNFA

  • Registered Nurse First Assistant
  • Portland, OR
National Provider Identifier
1104441153
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
201140393RN Issued in OR
Practice address
617 NW 112TH Ave
Portland, OR 97229-6118
Phone
(562) 704-9323
NPI assigned
Jun 15, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201140393RN OR
Registered Nurse First Assistant 163WR0006X 201140393RN OR Primary

Addresses

Primary practice location

617 NW 112TH Ave
Portland, OR 97229-6118

Mailing address

617 NW 112TH Ave
Portland, OR 97229-6118
Phone (562) 704-9323

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

LicenseStateTypeSpecialty
201140393RNORMDRegistered Nurse First Assistant

NPI Registry JSON

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1104441153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 NW 112TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972296118",
            "telephone_number": "562-704-9323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 NW 112TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972296118",
            "telephone_number": "562-704-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "KERI",
        "credential": "RN, CNOR, RNFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-15",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201140393RN",
            "primary": false
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "OR",
            "license": "201140393RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 6, 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.