Individual provider Active NPI

Laurence Eckman, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1316074453
Registry record updated Nov 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
200750006NP Issued in OR
Practice address
2311 E Burnside St Ste 100
Portland, OR 97214-1655
Phone
(503) 492-2200
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 200750006NP OR Primary

Addresses

Primary practice location

2311 E Burnside St Ste 100
Portland, OR 97214-1655

Mailing address

2311 E Burnside St Ste 100
Portland, OR 97214-1655
Phone (503) 492-2200

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

State licenses

LicenseStateTypeSpecialty
200750006NPORMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257206400000",
    "number": "1316074453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 E BURNSIDE ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141655",
            "telephone_number": "503-492-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 E BURNSIDE ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141655",
            "telephone_number": "503-492-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKMAN",
        "first_name": "LAURENCE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2009-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "200750006NP",
            "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 Nov 3, 2009; 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.