Individual provider Active NPI

Mickey Miqueli-Piazza, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1104701366
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10050055 Issued in OR
Practice address
13535 SW 72ND Ave Ste 170
Portland, OR 97223-8074
Phone
(971) 300-0654
NPI assigned
Aug 7, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN11040949 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11040949 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10050055 OR Primary

Addresses

Primary practice location

13535 SW 72ND Ave Ste 170
Portland, OR 97223-8074

Mailing address

455 Deer Creek Lake Point South LN
Deerfield Beach, FL 33442-8462
Phone (561) 906-9066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20251124003929 OR Practitioner - Nurse Practitioner 1658863956 Reassigns benefits to 1 organization
I20260215000165 WA Practitioner - Nurse Practitioner 1658863956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Florida State University College of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Robert Olsen MD LLCGroup PAC ID 7517354517, 25 clinicians

Practice addresses (Care Compare)

13535 SW 72ND Ave
Suite 170
Portland, OR 97223-8074
Phone (971) 300-0654

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11040949FLMDAcute Care Nurse Practitioner
10050055ORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Olsen MD LLC CurrentSince Oct 6, 2025 Accepting new patients
Robert Olsen MD Washington PC CurrentSince Nov 1, 2025 Accepting new patients

Locations

1925 NE Stucki Ave
Ste 270
Beaverton, OR 97006

250 NW Franklin Ave
Ste 204
Bend, OR 97703

9895 SE Sunnyside Rd
Ste F
Clackamas, OR 97015

1400 Executive Pkwy
Ste 250
Eugene, OR 97401

13535 SW 72nd Ave
Ste 170
Portland, OR 97223
Phone (303) 468-8018

833 SW 11th Ave
Ste 245
Portland, OR 97205
Phone (503) 442-6105

1547 NE 40th Ave
Ste B
Portland, OR 97232
Phone (855) 397-0197

2480 Liberty St NE
Ste 110
Salem, OR 97301
Phone (503) 371-1756

8501 E Mill Plain Blvd
Vancouver, WA 98664
Phone (360) 718-2346

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1754524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1104701366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 DEER CREEK LAKE POINT SOUTH LN",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334428462",
            "telephone_number": "561-906-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13535 SW 72ND AVE STE 170",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238074",
            "telephone_number": "971-300-0654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIQUELI-PIAZZA",
        "first_name": "MICKEY",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-07",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11040949",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11040949",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10050055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.