Individual provider Active NPI

Lucille Rose Tower Glick, CNM

  • Advanced Practice Midwife
  • Portland, OR
National Provider Identifier
1841775434
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
201808695NP-PP Issued in OR
Practice address
501 N Graham St Ste 550
Portland, OR 97227-2010
Phone
(503) 284-5220
Fax
(503) 284-4971
NPI assigned
Sep 28, 2018
Last updated
May 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 201808695NP-PP OR Primary

Addresses

Primary practice location

501 N Graham St Ste 550
Portland, OR 97227-2010

Mailing address

PO Box 2927
Portland, OR 97208-2927
Phone (503) 788-7273

Other practice location 1

3727 NE Martin Luther King Jr Blvd
Portland, OR 97212-1112
Phone (503) 788-7273

Other identifiers 1

IdentifierTypeStateIssuer
500756023MedicaidOR

Other names 1

  • Lucille Rose Tower Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cc_otoc_obgyn_north_front_desk_pool12223217@oc.providencedirect.org

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250603003475 OR Practitioner - Certified Nurse Midwife (CNM) 5395254023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians

Practice addresses (Care Compare)

501 N Graham St
Suite 550
Portland, OR 97227-2010
Phone (503) 284-5220

5050 NE Hoyt
Suite 655
Portland, OR 97213-2990
Phone (503) 239-6673

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
201808695NP-PPORMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
The Oregon Clinic PC CurrentSince Jun 1, 2025 Accepting new patients
The Oregon Clinic, PC CurrentSince Jun 1, 2025 Accepting new patients

Locations

501 N Graham St
Ste 550
Portland, OR 97227
Phone (503) 284-5220

5050 NE Hoyt St
Ste 655
Portland, OR 97213
Phone (503) 239-6673

541 NE 20th Ave
Ste 225
Portland, OR 97232
Phone (503) 963-2801

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1841775434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2927",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972082927",
            "telephone_number": "503-788-7273",
            "fax_number": "503-788-7285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST STE 550",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972272010",
            "telephone_number": "503-284-5220",
            "fax_number": "503-284-4971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3727 NE Martin Luther King Jr Blvd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972121112",
            "country_code": "US",
            "telephone_number": "503-788-7273",
            "fax_number": "503-788-7285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLICK",
        "first_name": "LUCILLE",
        "middle_name": "ROSE TOWER",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-28",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OR",
            "license": "201808695NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500756023",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cc_otoc_obgyn_north_front_desk_pool12223217@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "501 N Graham St Ste 550",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972272010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LUCILLE",
            "last_name": "TOWER",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.