Active NPI
Tamara Owen, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Portland, OR
National Provider Identifier
1497844484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Practice address
- 1924 NE Couch St
Portland, OR 97232-3023 - Phone
- (503) 788-7726
- Fax
- (503) 788-7729
- NPI assigned
- Oct 11, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | OR | Primary |
Addresses
Primary practice location
1924 NE Couch St
Portland, OR 97232-3023
Mailing address
PO Box 820134
Portland, OR 97282-1134
Phone (503) 788-7726
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000565 | Medicaid | OR |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160125001394 | OR | Order and Referring Only - Nurse Practitioner | 0840389664 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497844484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 820134",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972821134",
"telephone_number": "503-788-7726",
"fax_number": "503-788-7729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1924 NE COUCH ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972323023",
"telephone_number": "503-788-7726",
"fax_number": "503-788-7729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OWEN",
"first_name": "TAMARA",
"name_prefix": "Ms.",
"credential": "PMHNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "OR",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000565",
"state": "OR"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.