Individual provider Active NPI

Tara C O'Connor, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1780844332
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201250047NP Issued in OR
Practice address
4300 NE Fremont St Ste 260
Portland, OR 97213-1100
Phone
(816) 974-7570
Fax
(888) 301-1226
NPI assigned
Jun 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X N360139367 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201250047NP OR Primary

Addresses

Primary practice location

4300 NE Fremont St Ste 260
Portland, OR 97213-1100

Mailing address

4300 NE Fremont St Ste 260
Portland, OR 97213-1100
Phone (816) 974-7570

Other practice location 1

6700 SW 105th Ave Ste 211
Beaverton, OR 97008-8824
Phone (816) 974-7570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120501000285 OR Practitioner - Nurse Practitioner 2466587290 Reassigns benefits to 1 organization
Practice locations: Portland, OR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
N360139367WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Emanuel Hospital & Health Center CurrentSince May 4, 2018 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince May 4, 2018 Accepting new patients

Locations

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

1225 NE 2nd Ave
Portland, OR 97232
Phone (503) 413-5051

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1780844332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 NE FREMONT ST STE 260",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131100",
            "telephone_number": "816-974-7570",
            "fax_number": "888-301-1226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 NE FREMONT ST STE 260",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131100",
            "telephone_number": "816-974-7570",
            "fax_number": "888-301-1226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6700 SW 105th Ave Ste 211",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970088824",
            "country_code": "US",
            "telephone_number": "816-974-7570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "TARA",
        "middle_name": "C",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "N360139367",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201250047NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.