Individual provider Active NPI

Lily Baraka

  • School Registered Nurse
  • Portland, OR
National Provider Identifier
1336056100
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
201340637RN Issued in OR
Practice address
11611 NE Ainsworth Cir
Portland, OR 97220-9017
Phone
(971) 266-7582
NPI assigned
Aug 26, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 201340637RN OR Primary

Addresses

Primary practice location

11611 NE Ainsworth Cir
Portland, OR 97220-9017

Mailing address

11740 SE Main St
Portland, OR 97216-3958
Phone (971) 266-7582

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1787702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1336056100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11740 SE MAIN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972163958",
            "telephone_number": "971-266-7582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11611 NE AINSWORTH CIR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972209017",
            "telephone_number": "971-266-7582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARAKA",
        "first_name": "LILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-26",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "OR",
            "license": "201340637RN",
            "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 Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.