Brenda Davis Irvine, RN, IBCLC

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

078041248 Issued in OR

Practice address

1304 SE 58TH Ave
Portland, OR 97215-2728

Phone

(503) 701-1180

NPI assigned

Oct 15, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1649812207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 SE 58TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972152728",
            "telephone_number": "503-701-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 SE 58TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972152728",
            "telephone_number": "503-701-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRVINE",
        "first_name": "BRENDA",
        "middle_name": "DAVIS",
        "credential": "RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-15",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "078041248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://heart2heartlactation.com",
            "affiliation": "N",
            "address_1": "1304 SE 58th Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972152728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Candace Nichole Irvin
• Gary Irvin
• Jonathan Irvin, LAC.
• Michael Irvin
• Michal Irvin, MA
• Christina Irvine, PH.D.
• Christina Hamme Irvine, PSY.D.
• Debra Irvine, PT
• Douglas H Irvine, MD, PHD
• Carmel Therese Irving, MSW,LCSW

• Registered Nurse in Portland, OR
• Providers in Portland, OR by specialty
• Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.