Individual provider Active NPI

Colleen Eliza Nasreen Huntwork, RN, FNP

  • Primary Care Nurse Practitioner
  • Portland, OR
National Provider Identifier
1386979482
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
202010084NP-PP Issued in OR
Practice address
7035 SW Ivy LN Apt 56
Portland, OR 97225-1163
Phone
(503) 664-0684
NPI assigned
Oct 7, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201709396RN OR
Mechanotherapist 172M00000X 15472 OR
Family Nurse Practitioner 363LF0000X 202010084NP-PP OR
Primary Care Nurse Practitioner 363LP2300X 202010084NP-PP OR Primary

Addresses

Primary practice location

7035 SW Ivy LN Apt 56
Portland, OR 97225-1163

Mailing address

7035 SW Ivy LN Apt 56
Portland, OR 97225-1163
Phone (503) 664-0684

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
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
15472ORMDMechanotherapist
202010084NP-PPORMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Project Quest Past Accepting new patients

Organizations & group practices 1

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": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1386979482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7035 SW IVY LN APT 56",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251163",
            "telephone_number": "503-664-0684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7035 SW IVY LN APT 56",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251163",
            "telephone_number": "503-664-0684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNTWORK",
        "first_name": "COLLEEN",
        "middle_name": "ELIZA NASREEN",
        "credential": "RN, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-07",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201709396RN",
            "primary": false
        },
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "OR",
            "license": "15472",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202010084NP-PP",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OR",
            "license": "202010084NP-PP",
            "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 Feb 14, 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.