Active NPI
Lynn Ellis Eastes, ACNP
- Acute Care Nurse Practitioner
- Portland, OR
National Provider Identifier
1609881101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 089006048N0
- Practice address
- 3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011 - Phone
- (503) 494-8372
- NPI assigned
- Jul 31, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 089006048N0 | OR | Primary |
| Acute Care Nurse Practitioner | 363LA2100X | 089006048RN | OR |
Addresses
Primary practice location
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Mailing address
14210 SE 22ND Cir
Vancouver, WA 98683-8400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 275314 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
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": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609881101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14210 SE 22ND CIR",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986838400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393011",
"telephone_number": "503-494-8372"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EASTES",
"first_name": "LYNN",
"middle_name": "ELLIS",
"credential": "ACNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "OR",
"license": "089006048N0",
"primary": true
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "OR",
"license": "089006048RN",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "275314",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
- East Portland Peritoneal Dialysis Clinic, LLC (U.S. Renal Care East Portland Home Dialysis)
- East Portland Surgical Center LLC
- East Side Orthotics & Prosthetics, Inc.
- Adrienne East, LCSW
- Stephanie Ann East, MSW
- Anne Margaret Eastman, PH. D.
- Bruce L Eastman, FNP
- Laura Eastmond, DPT
- Eastmoreland Orthopedic Clinic, P.C.
- Eastmoreland Surgical Clinic
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 Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.