Individual provider Active NPI

Deborah Alice Prettyman

  • Specialist
  • Gladstone, OR
National Provider Identifier
1811282429
Registry record updated Jun 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
16271 Issued in OR
Practice address
970 Yale Ave
Gladstone, OR 97027-2178
Phone
(971) 242-9078
NPI assigned
Jun 10, 2011
Last updated
Jun 10, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 16271 OR Primary

Addresses

Primary practice location

970 Yale Ave
Gladstone, OR 97027-2178

Mailing address

970 Yale Ave
Gladstone, OR 97027-2178
Phone (971) 242-9078

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
16271ORMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307664000000",
    "number": "1811282429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 YALE AVE",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970272178",
            "telephone_number": "971-242-9078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 YALE AVE",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970272178",
            "telephone_number": "971-242-9078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRETTYMAN",
        "first_name": "DEBORAH",
        "middle_name": "ALICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-10",
        "last_updated": "2011-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "16271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladstone, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; 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.