Individual provider Active NPI

Brittney Tice, RN BSN

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1184237935
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10015389 Issued in OR
Practice address
5000 N Willamette Blvd
Portland, OR 97203-5743
Phone
(503) 943-7790
NPI assigned
Aug 30, 2020
Last updated
Oct 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X 201142260RN OR
Family Nurse Practitioner 363LF0000X 10015389 OR Primary

Addresses

Primary practice location

5000 N Willamette Blvd
Portland, OR 97203-5743

Mailing address

1823 SW Market St Apt 1
Portland, OR 97201-2445

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
I20240313004285 OR Practitioner - Nurse Practitioner 2860838737 Reassigns benefits to 1 organization
I20240927000373 WA Practitioner - Nurse Practitioner 2860838737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

2850 SE Powell Valley Rd
Gresham, OR 97080-1494
Phone (503) 666-5050

305 SE Chkalov Dr
Suite 170
Vancouver, WA 98683-5263
Phone (360) 799-3912

3425 SE 192ND Ave
Suite 106
Vancouver, WA 98683-1440
Phone (360) 205-2960

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
10015389ORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC CurrentSince Feb 29, 2024 Accepting new patients
Legacy Clinics LLC CurrentSince Feb 29, 2024 Accepting new patients
Legacy Salmon Creek Hospital Past Accepting new patients

Locations

2870 SW Cedar Hills Blvd
Beaverton, OR 97005
Phone (503) 646-9222

2850 SE Powell Valley Rd
Gresham, OR 97080
Phone (503) 666-5050

3 Monroe Pkwy
Ste X
Lake Oswego, OR 97035
Phone (503) 679-3748

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

4800 SW 76th Ave
Portland, OR 97225
Phone (971) 808-0665

21430 SW Langer Farms Pkwy
Ste 158
Sherwood, OR 97140
Phone (971) 808-0655

21900 Willamette Dr
Ste 209
West Linn, OR 97068
Phone (971) 274-0038

200 NE Mother Joseph Pl
Ste 410
Vancouver, WA 98664
Phone (503) 413-3580

305 SE Chkalov Dr
Ste 170
Vancouver, WA 98683
Phone (360) 799-3912

Organizations & group practices 3

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1598745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1184237935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1823 SW MARKET ST APT 1",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972012445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 N WILLAMETTE BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972035743",
            "telephone_number": "503-943-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICE",
        "first_name": "BRITTNEY",
        "credential": "RN BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-30",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "OR",
            "license": "201142260RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10015389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.