Individual provider Active NPI

Guadalupe Valerio

  • Licensed Practical Nurse
  • Portland, OR
National Provider Identifier
1790255503
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
093005079LPN Issued in OR
Practice address
324 NW Davis St
Portland, OR 97209-3925
Phone
(503) 502-0082
NPI assigned
Dec 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 093005079LPN OR Primary

Addresses

Primary practice location

324 NW Davis St
Portland, OR 97209-3925

Mailing address

324 NW Davis St
Portland, OR 97209-3925

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

State licenses

LicenseStateTypeSpecialty
093005079LPNORMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1790255503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 NW DAVIS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 NW DAVIS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093925",
            "telephone_number": "503-502-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALERIO",
        "first_name": "GUADALUPE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-05",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OR",
            "license": "093005079LPN",
            "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 Dec 5, 2018; 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.