Active NPI
Caitlin Hathaway
- Medical-Surgical Registered Nurse
- Gresham, OR
National Provider Identifier
1649861915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical-Surgical Registered Nurse
- License
- 201909928RN
- Practice address
- 150 SE 214TH Ave
Gresham, OR 97030-8450 - Phone
- (310) 424-0515
- NPI assigned
- Jan 29, 2021
- Last updated
- Jan 29, 2021
- 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 |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | 201909928RN | OR | Primary |
Addresses
Primary practice location
150 SE 214TH Ave
Gresham, OR 97030-8450
Mailing address
150 SE 214TH Ave
Gresham, OR 97030-8450
Phone (310) 424-0515
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
| License | State | Type | Specialty |
|---|---|---|---|
| 201909928RN | OR | MD | Medical-Surgical Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611878400000",
"number": "1649861915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 SE 214TH AVE",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970308450",
"telephone_number": "310-424-0515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 SE 214TH AVE",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970308450",
"telephone_number": "310-424-0515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HATHAWAY",
"first_name": "CAITLIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-29",
"last_updated": "2021-01-29",
"certification_date": "2021-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "163WM0705X",
"taxonomy_group": "",
"desc": "Registered Nurse, Medical-Surgical",
"state": "OR",
"license": "201909928RN",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jan 29, 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.