Active NPI
Erin R Medeiros, RN/QMHP-R
- Registered Nurse
- Portland, OR
National Provider Identifier
1639553563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 201507345RN
- Practice address
- 703 NE Hancock St
Portland, OR 97212-3955 - Phone
- (503) 230-9875
- Fax
- (503) 331-3441
- NPI assigned
- Jul 9, 2015
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 24-QMHP-R-2536 | OR | |
| Registered Nurse | 163W00000X | RN60589243 | WA | |
| Registered Nurse | 163W00000X | 201507345RN | OR | Primary |
Addresses
Primary practice location
703 NE Hancock St
Portland, OR 97212-3955
Mailing address
211 SE Caruthers St
Portland, OR 97214-4502
Phone (503) 224-1044
Other practice location 1
12360 E Burnside St
Portland, OR 97233-1042
Phone (971) 279-4800
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24-QMHP-R-2536 | OR | MD | Mental Health Counselor |
| 201507345RN | OR | MD | Registered Nurse |
| RN60589243 | WA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744848000000",
"number": "1639553563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 SE CARUTHERS ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972144502",
"telephone_number": "503-224-1044",
"fax_number": "971-260-0355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "703 NE HANCOCK ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972123955",
"telephone_number": "503-230-9875",
"fax_number": "503-331-3441"
}
],
"practiceLocations": [
{
"address_1": "12360 E Burnside St",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972331042",
"country_code": "US",
"telephone_number": "971-279-4800",
"fax_number": "971-279-2051",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEDEIROS",
"first_name": "ERIN",
"middle_name": "R",
"name_prefix": "Ms.",
"credential": "RN/QMHP-R",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-09",
"last_updated": "2025-04-17",
"certification_date": "2025-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "24-QMHP-R-2536",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN60589243",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OR",
"license": "201507345RN",
"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 Apr 17, 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.