Individual provider Active NPI

Mikaela C Gates, RNFA

  • Registered Nurse First Assistant
  • Portland, OR
National Provider Identifier
1336839786
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
201806815RN Issued in OR
Practice address
11786 SW Barnes Rd Ste 110
Portland, OR 97225-5926
Phone
(503) 924-2323
Fax
(503) 601-0569
NPI assigned
May 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 201806815RN OR Primary

Addresses

Primary practice location

11786 SW Barnes Rd Ste 110
Portland, OR 97225-5926

Mailing address

11786 SW Barnes Rd Ste 110
Portland, OR 97225-5926
Phone (503) 924-2323

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

LicenseStateTypeSpecialty
201806815RNORMDRegistered Nurse First Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Skyline Oral Facial and Dental Implant Surgery CurrentSince Dec 10, 2023 Accepting new patients
Brett a. Ueeck DMD, MD, PC CurrentSince May 14, 2023 Accepting new patients

Locations

11786 SW Barnes Rd
Ste 110
Portland, OR 97225
Phone (503) 444-6444

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1336839786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11786 SW BARNES RD STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255926",
            "telephone_number": "503-924-2323",
            "fax_number": "503-601-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11786 SW BARNES RD STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255926",
            "telephone_number": "503-924-2323",
            "fax_number": "503-601-0569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATES",
        "first_name": "MIKAELA",
        "middle_name": "C",
        "credential": "RNFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "OR",
            "license": "201806815RN",
            "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 May 9, 2023; 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.