Organization Active NPI

Healing Presence Family Practice, PC

  • Primary Care Clinic/Center
  • Wilsonville, OR
National Provider Identifier
1376768572
Registry record updated Jul 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
HEALING PRESENCE FAMILY PRACTICE, PC
Practice address
30250 SW Parkway Ave
Suite 7
Wilsonville, OR 97070-9757
Phone
(503) 819-9726
NPI assigned
Apr 16, 2007
Last updated
Jul 31, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2007

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

Authorized official

Name
Carla Rayne Anderson, FNP-CNPI 1144211913
Title
Owner
Phone
(503) 819-9726

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X OR Primary

Addresses

Primary practice location

30250 SW Parkway Ave
Suite 7
Wilsonville, OR 97070-9757

Mailing address

29030 SW Town Center Loop E
Suite 202 PO Box 260
Wilsonville, OR 97070-9490
Phone (503) 819-9726

Other identifiers 1

IdentifierTypeStateIssuer
070131MedicaidOR

National Provider Directory

National Provider Directory

Locations

30250 SW Parkway Ave
Ste 7
Wilsonville, OR 97070
Phone (503) 570-3366

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185840000000",
    "number": "1376768572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29030 SW TOWN CENTER LOOP E",
            "address_2": "SUITE 202 PO BOX 260",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709490",
            "telephone_number": "503-819-9726",
            "fax_number": "503-582-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30250 SW PARKWAY AVE",
            "address_2": "SUITE 7",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709757",
            "telephone_number": "503-819-9726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING PRESENCE FAMILY PRACTICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-31",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "CARLA",
        "authorized_official_middle_name": "RAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-819-9726",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070131",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilsonville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2007; 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.