Edward Nigel Guillery, M.D.

Primary specialty

Pediatric Nephrology PhysicianTaxonomy code 2080P0210X

License

MD25092 Issued in OR

Practice address

501 N Graham St
Suite 340
Portland, OR 97227-1654

Phone

(503) 280-3620

Fax

(503) 282-2395

NPI assigned

Mar 10, 2006

Last updated

Feb 4, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1710955018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST",
            "address_2": "SUITE 340",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271654",
            "telephone_number": "503-280-3620",
            "fax_number": "503-282-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST",
            "address_2": "SUITE 340",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271654",
            "telephone_number": "503-280-3620",
            "fax_number": "503-282-2395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLERY",
        "first_name": "EDWARD",
        "middle_name": "NIGEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "WA",
            "license": "MD00044900",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "OR",
            "license": "MD25092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275191",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Northwest Permanente PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "14406 NE 20th Ave",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986861448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gina Guillaume
• Nahomie Moise Guillaume, MASTERS DEGREE/LMFT
• Jolie Guillebeau
• Bryan Raphael Guillen, MS
• Danielle Anees Guillen
• Glenn R Guillory III, DPT
• Kayla Kealoha Guillory, RD
• Florian Henri Guillot, MD
• Alexander R Guimaraes, MD PHD
• Brianna Guimond, MA

• Pediatric Nephrology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Pediatric Nephrology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.