Active NPI
Bette Gay Seagren, FNP
- Primary Care Nurse Practitioner
- Canby, OR
National Provider Identifier
1790969491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 000037573N1
- Practice address
- 143 NW 4TH Ave
Canby, OR 97013-3101 - Phone
- (503) 263-6611
- Fax
- (503) 266-5674
- NPI assigned
- Dec 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 000037573N1 | OR | Primary |
Addresses
Primary practice location
143 NW 4TH Ave
Canby, OR 97013-3101
Mailing address
143 NW 4TH Ave
Canby, OR 97013-3101
Phone (503) 263-6611
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 282467 | Medicaid | OR |
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)
- Enrolled
- Credentials
- Nurse Practitioner
Interoperability endpoints
- https://api.platform.athenahealth.com/23575/brand/1/csg/1/fhir/r4
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287964800000",
"number": "1790969491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "143 NW 4TH AVE",
"city": "CANBY",
"state": "OR",
"postal_code": "970133101",
"telephone_number": "503-263-6611",
"fax_number": "503-266-5674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "143 NW 4TH AVE",
"city": "CANBY",
"state": "OR",
"postal_code": "970133101",
"telephone_number": "503-263-6611",
"fax_number": "503-266-5674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEAGREN",
"first_name": "BETTE",
"middle_name": "GAY",
"name_prefix": "Mrs.",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-18",
"last_updated": "2010-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "OR",
"license": "000037573N1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "282467",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Canby, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.