Individual provider Active NPI

Erica Lynn Simonich, WHNP

  • Women's Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1396083242
Registry record updated Mar 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
201400201NP-PP Issued in OR
Practice address
1901 N Killingsworth St
Portland, OR 97217-4436
Phone
(503) 770-0670
Fax
(833) 450-6082
NPI assigned
Jan 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60577137 WA
Women's Health Nurse Practitioner 363LW0102X 721409 TX
Women's Health Nurse Practitioner 363LW0102X 201400201NP-PP OR Primary

Addresses

Primary practice location

1901 N Killingsworth St
Portland, OR 97217-4436

Mailing address

1901 N Killingsworth St
Portland, OR 97217-4436
Phone (503) 770-0670

Other identifiers 2

IdentifierTypeStateIssuer
2035849MedicaidWA
500670034MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160123000069 OR Practitioner - Nurse Practitioner 4385947472 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP60577137WAMDNurse Practitioner
721409TXMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Oregon Clinic, PC CurrentSince Jan 18, 2016 Accepting new patients
Portland Wellness Project LLC CurrentSince Sep 15, 2025 Accepting new patients
The Oregon Clinic PC CurrentSince Jan 18, 2016 Accepting new patients

Locations

5050 NE Hoyt St
Ste 655
Portland, OR 97213
Phone (503) 239-6673

541 NE 20th Ave
Ste 225
Portland, OR 97232
Phone (503) 963-2801

1901 N Killingsworth St
Portland, OR 97217
Phone (503) 770-0670

501 N Graham St
Ste 550
Portland, OR 97227
Phone (503) 284-5220

847 NE 19th Ave
Ste 300
Portland, OR 97232

Interoperability endpoints

  • Direct secure messaging: erica.simonich.1@27952.direct.athenahealth.com

Organizations & group practices 3

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": "1359331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743292800000",
    "number": "1396083242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 N KILLINGSWORTH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972174436",
            "telephone_number": "503-770-0670",
            "fax_number": "833-450-6082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 N KILLINGSWORTH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972174436",
            "telephone_number": "503-770-0670",
            "fax_number": "833-450-6082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONICH",
        "first_name": "ERICA",
        "middle_name": "LYNN",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-28",
        "last_updated": "2025-03-30",
        "certification_date": "2025-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60577137",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "721409",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OR",
            "license": "201400201NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2035849",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500670034",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.