Individual provider Active NPI

Laurie Diane Swan, RN

  • Registered Nurse
  • Portland, OR
National Provider Identifier
1265650907
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
Practice address
722 NE 162ND Ave
Portland, OR 97230-5760
Phone
(503) 408-5016
Fax
(503) 255-5094
NPI assigned
Apr 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X OR Primary

Addresses

Primary practice location

722 NE 162ND Ave
Portland, OR 97230-5760

Mailing address

PO Box 713
Troutdale, OR 97060-0713
Phone (503) 663-2258

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

LicenseStateTypeSpecialty
093000286RNORMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265650907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713",
            "city": "TROUTDALE",
            "state": "OR",
            "postal_code": "970600713",
            "telephone_number": "503-663-2258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 NE 162ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972305760",
            "telephone_number": "503-408-5016",
            "fax_number": "503-255-5094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAN",
        "first_name": "LAURIE",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 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.