Active NPI
Tamara Gedrose, RN
- Registered Nurse
- Seaside, OR
National Provider Identifier
1114541745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 201042536RN
- Practice address
- 1150 N Roosevelt Dr Apt 104
Seaside, OR 97138-7053 - Phone
- (503) 717-7150
- NPI assigned
- May 29, 2020
- Last updated
- May 29, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 201042536RN | OR | Primary |
Addresses
Primary practice location
1150 N Roosevelt Dr Apt 104
Seaside, OR 97138-7053
Mailing address
4400 NE Halsey St Ste 200
Portland, OR 97213-1545
Phone (503) 215-6556
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://www.providence.org/default | Other |
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 |
|---|---|---|---|
| 201042536RN | OR | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590710400000",
"number": "1114541745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4400 NE HALSEY ST STE 200",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972131545",
"telephone_number": "503-215-6556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1150 N ROOSEVELT DR APT 104",
"city": "SEASIDE",
"state": "OR",
"postal_code": "971387053",
"telephone_number": "503-717-7150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEDROSE",
"first_name": "TAMARA",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-29",
"last_updated": "2020-05-29",
"certification_date": "2020-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OR",
"license": "201042536RN",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://www.providence.org/default",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "Info",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Info",
"address_1": "1150 N Roosevelt Dr Apt 104",
"city": "Seaside",
"state": "OR",
"country_code": "US",
"postal_code": "971387053",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Seaside, OR
- Kathleen Renee Flewelling, N.D.
- Forest Drive Operations, LLC (Suzanne Elise Assisted Living Facility)
- Michael J Forrest, P.A.
- Lisa Ann French, LMT
- Kaylin Faith Gaunt
- Gibbs Natural Healing Centre, PC
- Edwin Charles Gibbs, DC ND LAC
- Mary Ann Gibbs, DC
- Cynthia Machelle Gonzalez, CADC II, QMHA-C
- Lindsay Diane Goodman, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.