Vicki Collister, ANP

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

087000014N3 Issued in OR

Practice address

4805 NE Glisan St
Portland, OR 97213-2933

Phone

(503) 215-4620

Fax

(503) 215-4846

NPI assigned

Jul 11, 2006

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 names 1

• Vicki Kay Collister Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144255175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3178",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083178",
            "telephone_number": "503-215-6494",
            "fax_number": "503-215-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-215-4620",
            "fax_number": "503-215-4846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLISTER",
        "first_name": "VICKI",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "087000014N3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICKI",
            "last_name": "COLLISTER",
            "middle_name": "KAY",
            "credential": "ANP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Valerie Coleen Collins, D.O.
• Victoria A Collins, DC
• Zachery D Collins, OT
• Maria Marguerite Collinsworth
• Eric Collison
• Laila Collman
• Jessica Nikole Collopy, R.D., M.S., CSR
• Elizabeth Kathleen Collumb, MD
• Julie Anna Collura, LCSW
• Laurence Colman, MD GENERAL SURGEON

• Registered Nurse in Portland, OR
• Providers in Portland, OR by specialty
• Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.