Individual provider Active NPI

Renee Tatanya Craven

  • Registered Nurse
  • Portland, OR
National Provider Identifier
1619851789
Registry record updated Aug 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
201391047RN Issued in OR
Practice address
7912 SE 52ND Ave
Portland, OR 97206-9122
Phone
(971) 275-0212
NPI assigned
Aug 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201391047RN OR Primary

Addresses

Primary practice location

7912 SE 52ND Ave
Portland, OR 97206-9122

Mailing address

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (503) 813-2000

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
201391047RNORMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1754092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754092800000",
    "number": "1619851789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10180 SE SUNNYSIDE RD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970158970",
            "telephone_number": "503-813-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7912 SE 52ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972069122",
            "telephone_number": "971-275-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAVEN",
        "first_name": "RENEE",
        "middle_name": "TATANYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-02",
        "last_updated": "2025-08-02",
        "certification_date": "2025-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201391047RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.