Active NPI
Colleen Eliza Nasreen Huntwork, RN, FNP
- Primary Care Nurse Practitioner
- Portland, OR
National Provider Identifier
1386979482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 202010084NP-PP
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 15472 | OR | MD | Mechanotherapist |
| 202010084NP-PP | OR | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Specialist
- Portland, OR
- NPI 1134458052
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.