Danielle Leyla Blackwell, FNP
Individual provider Active NPI Nurse Practitioner · Oregon City, OR
NPI 1366400293 · NPPES record last updated Jun 5, 2015
Key facts
- NPI
- 1366400293
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 200150108NP (OR)
- Practice address
- 19723 S Hwy 213
Oregon City, OR 97045-4190 - Phone
- (503) 656-9030
- Fax
- (503) 656-9026
- NPI assigned
- May 2, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200150108NPFNPPP | OR | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beaverton Family Medicine | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 200150108NPFNPPP | OR | |
| Nurse Practitioner | 363L00000X | 200150108NP | OR | Yes |
Addresses
Primary practice location
19723 S Hwy 213
Oregon City, OR 97045-4190
Mailing address
728 Molalla Ave
Suite Ab
Oregon City, OR 97045
Phone (503) 656-9030
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 262804 | Medicaid | OR |
Other providers in Oregon City, OR
- Margaret Bibby
- Helen Bicart
- Dilek A Bishku
- Amy C Black
- Bradford T Black
- Vincent Blaney
- Amanda Heather Blasi
- Chad Bliss
- Kelly Blixhavn
- Michelle Renee Bloemers
All providers in Oregon City, OR · Nurse Practitioner in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.