Active NPI
Mary Joan E Laufer, WHCNP
- Women's Health Nurse Practitioner
- Portland, OR
National Provider Identifier
1225061658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 200650059NP
- Practice address
- 3181 SW Sam Jackson Park Rd
KPV 7M
Portland, OR 97239-3011 - Phone
- (503) 418-8048
- NPI assigned
- Jul 9, 2006
- 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 |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 200650059NP | OR | Primary |
Addresses
Primary practice location
3181 SW Sam Jackson Park Rd
KPV 7M
Portland, OR 97239-3011
Mailing address
3181 SW Sam Jackson Park Rd
Mail Code KPVC
Portland, OR 97239-3011
Phone (503) 418-8048
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9633264 | Medicaid | WA | |
| 274210 | Medicaid | OR | |
| 0157152 | Other | WA | L&I |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200650059NP | OR | MD | Women's Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361318400000",
"number": "1225061658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD",
"address_2": "MAIL CODE KPVC",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393011",
"telephone_number": "503-418-8048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD",
"address_2": "KPV 7M",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393011",
"telephone_number": "503-418-8048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAUFER",
"first_name": "MARY JOAN",
"middle_name": "E",
"credential": "WHCNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-09",
"last_updated": "2013-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "OR",
"license": "200650059NP",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9633264",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "274210",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I",
"identifier": "0157152",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.