Individual provider Active NPI

Elise Wawrzyn, RN

  • Registered Nurse
  • Eugene, OR
National Provider Identifier
1770295503
Registry record updated Dec 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
202107695RN Issued in OR
Practice address
151 W 7TH Ave Ste 520
Eugene, OR 97401-2676
Phone
(541) 682-4035
NPI assigned
Dec 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2022

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 202107695RN OR Primary

Addresses

Primary practice location

151 W 7TH Ave Ste 520
Eugene, OR 97401-2676

Mailing address

89467 Territorial Rd
Elmira, OR 97437-9748
Phone (414) 530-6272

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

LicenseStateTypeSpecialty
202107695RNORMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1672012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672012800000",
    "number": "1770295503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89467 TERRITORIAL RD",
            "city": "ELMIRA",
            "state": "OR",
            "postal_code": "974379748",
            "telephone_number": "414-530-6272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 W 7TH AVE STE 520",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012676",
            "telephone_number": "541-682-4035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAWRZYN",
        "first_name": "ELISE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-26",
        "last_updated": "2022-12-26",
        "certification_date": "2022-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "202107695RN",
            "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 Dec 26, 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.