Active NPI
Brandee Ione Grider, LMT, CPM, LDM
- Midwife
- Portland, OR
National Provider Identifier
1306151790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 018943
- Practice address
- 3800 NE Sandy Blvd
Suite 112
Portland, OR 97232-1836 - Phone
- (503) 679-8323
- NPI assigned
- Aug 10, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 018943 | OR | Primary |
| Massage Therapist | 225700000X | 11417 | OR |
Addresses
Primary practice location
3800 NE Sandy Blvd
Suite 112
Portland, OR 97232-1836
Mailing address
3800 NE Sandy Blvd
Suite 112
Portland, OR 97232-1836
Phone (503) 679-8323
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018943 | OR | MD | Midwife |
| 11417 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281398400000",
"number": "1306151790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3800 NE SANDY BLVD",
"address_2": "SUITE 112",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972321836",
"telephone_number": "503-679-8323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3800 NE SANDY BLVD",
"address_2": "SUITE 112",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972321836",
"telephone_number": "503-679-8323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIDER",
"first_name": "BRANDEE",
"middle_name": "IONE",
"credential": "LMT, CPM, LDM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-10",
"last_updated": "2010-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "OR",
"license": "018943",
"primary": true
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "11417",
"primary": false
}
],
"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 Aug 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.