Andrea G. Pace, FNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

200850135NP Issued in OR

Practice address

5 Centerpointe Dr
Lake Oswego, OR 97035-8651

Phone

(541) 246-0739

NPI assigned

Jul 13, 2009

Last updated

Jul 31, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Andrea Comisky Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1700015666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CENTERPOINTE DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358651",
            "telephone_number": "541-246-0739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CENTERPOINTE DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358651",
            "telephone_number": "541-246-0739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACE",
        "first_name": "ANDREA",
        "middle_name": "G.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-13",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200850135NP",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "200850135NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "COMISKY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Gerontology Nurse Practitioner in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Gerontology Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; 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.