Elizabeth Pruett, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

097000577N2NP-PP Issued in OR

Practice address

22300 SW Boones Ferry Rd
Tualatin, OR 97062-7373

Phone

(503) 941-3180

NPI assigned

Jun 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Neighborhood Health Center

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1174820815
  Medicare reassignment NPD
• Neighborhood Health Center

  • Federally Qualified Health Center (FQHC)
  • Canby, OR
  • NPI 1033489224
  NPD
• Neighborhood Health Center

  • Federally Qualified Health Center (FQHC)
  • Hillsboro, OR
  • NPI 1356725998
  NPD
• Neighborhood Health Center

  • Federally Qualified Health Center (FQHC)
  • Milwaukie, OR
  • NPI 1083984264
  NPD (past)
• Neighborhood Health Center

  • Federally Qualified Health Center (FQHC)
  • Oregon City, OR
  • NPI 1457902561
  NPD (past)
• Virginia Garcia Memorial Health Center

  • Federally Qualified Health Center (FQHC)
  • Tigard, OR
  • NPI 1194099234
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1831131747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7320 SW HUNZIKER RD STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972232302",
            "telephone_number": "503-941-3033",
            "fax_number": "503-747-7013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22300 SW BOONES FERRY RD",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970627373",
            "telephone_number": "503-941-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUETT",
        "first_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OR",
            "license": "097000577N2NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "237041",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Prentice, APRN-RX
• Jessica Preston
• Molly Ann Prideaux
• Prine Counseling, LLC
• Proactive Physical Therapy Tualatin
• Anela Puljic, MD
• Emily W Puterbaugh, MD
• Josiah Daniel Pyles, LMT
• Radiation Oncology Specialists PC
• Anna Luisa Raffaelli, CNM

• Pediatric Nurse Practitioner in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Pediatric Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.