Active NPI
Greta Katherine Larson, ARNP
- Family Nurse Practitioner
- Gresham, OR
National Provider Identifier
1619204583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 201391240NP-PP
- Practice address
- 440 NW Division St
Gresham, OR 97030-5506 - Phone
- (503) 215-9500
- NPI assigned
- Nov 12, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 201391240NP-PP | OR | Primary |
Addresses
Primary practice location
440 NW Division St
Gresham, OR 97030-5506
Mailing address
PO Box 3158
Portland, OR 97208-3158
Other practice location 1
7410 Delaware Ln
Vancouver, WA 98664-1408
Phone (360) 896-5128
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500660728 | Medicaid | OR |
Other names 1
- Greta Katherine Meyers
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | glarson307896@oc.providencedirect.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
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": "1257984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616112000000",
"number": "1619204583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3158",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "440 NW DIVISION ST",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970305506",
"telephone_number": "503-215-9500"
}
],
"practiceLocations": [
{
"address_1": "7410 Delaware Ln",
"address_purpose": "LOCATION",
"city": "Vancouver",
"state": "WA",
"postal_code": "986641408",
"country_code": "US",
"telephone_number": "360-896-5128",
"fax_number": "360-896-5179",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LARSON",
"first_name": "GRETA",
"middle_name": "KATHERINE",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-12",
"last_updated": "2021-03-19",
"certification_date": "2021-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OR",
"license": "201391240NP-PP",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500660728",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "glarson307896@oc.providencedirect.org",
"affiliation": "N",
"address_1": "440 NW Division St",
"city": "Gresham",
"state": "OR",
"country_code": "US",
"postal_code": "970305506",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "GRETA",
"last_name": "MEYERS",
"middle_name": "KATHERINE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.