Individual provider Active NPI

Isaiah Roberto Lightdancer, RN

  • Registered Nurse
  • Eugene, OR
National Provider Identifier
1659286300
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
10065585 Issued in OR
Practice address
3990 W Amazon Dr
Eugene, OR 97405-4588
Phone
(541) 968-9449
NPI assigned
Aug 17, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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 10065585 OR Primary

Addresses

Primary practice location

3990 W Amazon Dr
Eugene, OR 97405-4588

Mailing address

3990 W Amazon Dr
Eugene, OR 97405-4588
Phone (541) 968-9449

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

NPI Registry JSON

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

{
    "created_epoch": "1786924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1659286300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3990 W AMAZON DR",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974054588",
            "telephone_number": "541-968-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 W AMAZON DR",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974054588",
            "telephone_number": "541-968-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHTDANCER",
        "first_name": "ISAIAH",
        "middle_name": "ROBERTO",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-17",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "10065585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; 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.