PNW Wound Care

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

Legal business name

PNW WOUND CARE

Doing business as

PNW Wound Care

Practice address

3810 Pacific Blvd SW
Albany, OR 97321-7752

Phone

(541) 390-3858

Fax

(541) 666-3752

NPI assigned

May 8, 2025

Organization subpart

No

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

Authorized official

Name

Brandy Tolliver, NPNPI 1306370432

Title

Owner

Phone

(541) 390-3858

Specialties & licenses 2

Addresses

Other names 1

• PNW Wound Care Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brandy Tolliver, APN

  • Adult Health Nurse Practitioner
  • Albany, OR
  • NPI 1306370432
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1746662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1609666064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 PACIFIC BLVD SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973217752",
            "telephone_number": "541-390-3858",
            "fax_number": "541-666-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 PACIFIC BLVD SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973217752",
            "telephone_number": "541-390-3858",
            "fax_number": "541-666-3752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PNW WOUND CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-08",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "TOLLIVER",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-390-3858",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PNW Wound Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Celia Marisol Pineda
• Benjamin Pinkham, RN
• Alex Jordan Pittman, DO
• Matthew Thomas Pivovar, PA-C
• Rosa E Plascencia, LCSW
• Rachel Mae Poff, RN
• Tristan Poirier
• Allison Poletti, M.A.
• Diane Janel Popp, LCSW
• Cori Porter, LMT

• Gerontology Nurse Practitioner in Albany, OR
• Providers in Albany, OR by specialty
• Gerontology Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.