Individual provider Active NPI

Tawna Renee Pangborn, FNP

  • Family Nurse Practitioner
  • Tualatin, OR
National Provider Identifier
1619969771
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
200450062NP Issued in OR
Practice address
19250 SW 90TH Ave
Tualatin, OR 97062-7585
Phone
(503) 692-3750
Fax
(503) 691-2324
NPI assigned
Aug 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 200450062NP OR Primary

Addresses

Primary practice location

19250 SW 90TH Ave
Tualatin, OR 97062-7585

Mailing address

541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801

Other practice location 1

1508 Division St Ste 15
Oregon City, OR 97045-1583
Phone (503) 692-3750

Other practice location 2

879 N Providence Dr
Newberg, OR 97132-7563
Phone (503) 692-3750

Other identifiers 2

IdentifierTypeStateIssuer
1060461MedicaidWA
213419MedicaidOR

Other names 1

  • Tawna Renee Adams-Pangborn Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cc_otoc_gastro_south_front_desk_pool12223286@oc.providencedirect.org The Oregon Clinic PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050721000442 OR Practitioner - Nurse Practitioner 7911934930 Reassigns benefits to 2 organizations
I20101018000903 WA Practitioner - Nurse Practitioner 7911934930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians

Practice addresses (Care Compare)

19250 SW 90TH Ave
Tualatin, OR 97062-7585
Phone (503) 692-3750

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Clinic PC CurrentSince Sep 16, 2024 Accepting new patients
Northwest Cancer Specialists PC CurrentSince Apr 21, 2008 Accepting new patients
The Oregon Clinic, PC CurrentSince Sep 16, 2024 Accepting new patients
Northwest Cancer Specialists PC CurrentSince Apr 21, 2008 Accepting new patients
The Oregon Clinic PC Current Accepting new patients

Locations

879 N Providence Dr
Newberg, OR 97132
Phone (503) 297-3778

1508 Division St
Ste 15
Oregon City, OR 97045
Phone (503) 657-5555

265 N Broadway
Portland, OR 97227
Phone (503) 280-1223

541 NE 20th Ave
Ste 225
Portland, OR 97232
Phone (503) 963-2801

5050 NE Hoyt St
Ste 655
Portland, OR 97213
Phone (503) 239-6673

500 N Highway
Saint Helens, OR 97051
Phone (503) 229-7554

19260 SW 65th Ave
Ste 435
Tualatin, OR 97062
Phone (503) 692-2032

19250 SW 90th Ave
Tualatin, OR 97062
Phone (503) 692-3750

210 SE 136th Ave
Vancouver, WA 98684
Phone (360) 944-9889

Interoperability endpoints

  • Direct secure messaging: tawna.pangborn@compass.ikm.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1619969771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19250 SW 90TH AVE",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970627585",
            "telephone_number": "503-692-3750",
            "fax_number": "503-691-2324"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1508 Division St Ste 15",
            "address_purpose": "LOCATION",
            "city": "Oregon City",
            "state": "OR",
            "postal_code": "970451583",
            "country_code": "US",
            "telephone_number": "503-692-3750",
            "fax_number": "503-691-2324",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "879 N Providence Dr",
            "address_purpose": "LOCATION",
            "city": "Newberg",
            "state": "OR",
            "postal_code": "971327563",
            "country_code": "US",
            "telephone_number": "503-692-3750",
            "fax_number": "503-691-2324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANGBORN",
        "first_name": "TAWNA",
        "middle_name": "RENEE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200450062NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1060461",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213419",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cc_otoc_gastro_south_front_desk_pool12223286@oc.providencedirect.org",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "19250 SW 90th Ave",
            "city": "Tualatin",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970627585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TAWNA",
            "last_name": "ADAMS-PANGBORN",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tualatin, OR

Sources for this page

Verify at the official NPI Registry.