Nanette Elaine Dudley Dahlquist, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD14724 Issued in OR

Practice address

445 E Main St
Hillsboro, OR 97123-4084

Phone

(503) 640-2757

Fax

(503) 640-9753

NPI assigned

Sep 29, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Nanette Elaine Dudley Dahlquist Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Hillsboro Pediatric Clinic LLC

  • Pediatrics Physician
  • Hillsboro, OR
  • NPI 1245312842
  Medicare reassignment NPD

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365638400000",
    "number": "1114914629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 E MAIN ST",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971234084",
            "telephone_number": "503-640-2757",
            "fax_number": "503-640-9753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 E MAIN ST",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971234084",
            "telephone_number": "503-640-2757",
            "fax_number": "503-640-9753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLQUIST",
        "first_name": "NANETTE",
        "middle_name": "ELAINE DUDLEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2013-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD14724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "023873004",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "R163731",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055830",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2758602",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANETTE",
            "last_name": "DUDLEY DAHLQUIST",
            "middle_name": "ELAINE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Samantha Joyce Curtis
• Derrick Eugene Custino, M.D.
• Sarah Catherine D'Ambrosio, ANP-BC, WHNP-BC
• Ethan Ray Canlas Dado, DPT
• Lauren Beth Dahl, LCSW
• Laura Elizabeth Daily
• Juhi Milind Dalal
• Anna Dale, LMT
• Marta Dale
• Kathleen Casey Dalke, MD

• Pediatrics Physician in Hillsboro, OR
• Providers in Hillsboro, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.