Active NPI
Renee Marie Oldham, RN
- Registered Nurse
- Portland, OR
National Provider Identifier
1730528837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 201041718RN
- Practice address
- 722 NE 162ND Ave
Portland, OR 97230-5760 - Phone
- (503) 408-5016
- Fax
- (503) 255-5094
- NPI assigned
- Jun 21, 2013
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 201041718RN | OR | Primary |
Addresses
Primary practice location
722 NE 162ND Ave
Portland, OR 97230-5760
Mailing address
3940 NW 148TH PL
Portland, OR 97229-0978
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201041718RN | OR | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371772800000",
"number": "1730528837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3940 NW 148TH PL",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972290978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "722 NE 162ND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972305760",
"telephone_number": "503-408-5016",
"fax_number": "503-255-5094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLDHAM",
"first_name": "RENEE",
"middle_name": "MARIE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-21",
"last_updated": "2013-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OR",
"license": "201041718RN",
"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 Jun 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.