Active NPI
Brenda M Faller, RPA/RA, RT(R)
- Radiology Practitioner Assistant
- Portland, OR
National Provider Identifier
1699942011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiology Practitioner Assistant
- License
- 06 WA 1235
- Practice address
- 545 NE 47TH Ave
Suite 215
Portland, OR 97213-2238 - Phone
- (971) 344-0499
- NPI assigned
- May 14, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiologic Technologist | 247100000X | 106318 | OR | |
| Radiology Practitioner Assistant | 243U00000X | 06 WA 1235 | Primary |
Addresses
Primary practice location
545 NE 47TH Ave
Suite 215
Portland, OR 97213-2238
Mailing address
545 NE 47TH Ave
Suite 215
Portland, OR 97213-2238
Phone (971) 344-0499
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 |
|---|---|---|---|
| 106318 | OR | MD | Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223856000000",
"number": "1699942011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "545 NE 47TH AVE",
"address_2": "SUITE 215",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972132238",
"telephone_number": "971-344-0499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "545 NE 47TH AVE",
"address_2": "SUITE 215",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972132238",
"telephone_number": "971-344-0499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FALLER",
"first_name": "BRENDA",
"middle_name": "M",
"credential": "RPA/RA, RT(R)",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-14",
"last_updated": "2008-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "247100000X",
"taxonomy_group": "",
"desc": "Radiologic Technologist",
"state": "OR",
"license": "106318",
"primary": false
},
{
"code": "243U00000X",
"taxonomy_group": "",
"desc": "Radiology Practitioner Assistant",
"state": null,
"license": "06 WA 1235",
"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 Oct 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.