Individual provider Active NPI

Nanette G Zunkel, DNP/FNP

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1396188488
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201505394NP-PP Issued in OR
Practice address
619 NW 6TH Ave FL 7
Portland, OR 97209-3991
Phone
(971) 940-3149
NPI assigned
Apr 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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 095007085RN OR
Registered Nurse 163W00000X RN61280814 WA
Nurse Practitioner 363L00000X AP60770487 WA
Family Nurse Practitioner 363LF0000X 201505394NP-PP OR Primary

Addresses

Primary practice location

619 NW 6TH Ave FL 7
Portland, OR 97209-3991

Mailing address

619 NW 6TH Ave FL 5
Portland, OR 97209-3991
Phone (971) 940-3149

Other identifiers 1

IdentifierTypeStateIssuer
022959MedicaidOR

Other names 1

  • Nan G Zunkel Other name

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
I20170810000613 OR Practitioner - Nurse Practitioner 0648541557 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN61280814WAMDRegistered Nurse
AP60770487WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Multnomah County Current Accepting new patients
Multnomah County CurrentSince Jan 23, 2024 Accepting new patients
Multnomah County CurrentSince Jan 23, 2024 Accepting new patients

Locations

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

619 NW 6th Ave
Fl 5
Portland, OR 97209
Phone (503) 988-3674

619 NW 6th Ave
Fl 7
Portland, OR 97209
Phone (503) 505-2127

Interoperability endpoints

  • Direct secure messaging: nzunkel121261@direct.ochin.org

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": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1396188488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 NW 6TH AVE FL 5",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093991",
            "telephone_number": "971-940-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 NW 6TH AVE FL 7",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093991",
            "telephone_number": "971-940-3149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUNKEL",
        "first_name": "NANETTE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DNP/FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "095007085RN",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN61280814",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60770487",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201505394NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022959",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NAN",
            "last_name": "ZUNKEL",
            "middle_name": "G",
            "credential": "DNP/FNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.