Treva Sakura Drake

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

201909401RN Issued in OR

Practice address

1111 NW Naito Pkwy
Portland, OR 97209-2596

Phone

(503) 488-7720

NPI assigned

Jan 15, 2020

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 names 1

• Treva Jackson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1932749173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 NW 6TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093609",
            "telephone_number": "503-294-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 NW NAITO PKWY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092596",
            "telephone_number": "503-488-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "TREVA",
        "middle_name": "SAKURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201909401RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TREVA",
            "last_name": "JACKSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Riane Drake
• Karen Lynn Drake, M.A.
• Kathleen Ann Drake, CADC I NCAC I
• Matthew Georgenson Drake, M.D.
• Sunny L Drake, DMD, MS
• Ian Thomas Drakulich, LPN
• Jason Draper
• Morgan Draps, PTA
• Derek Drasen, PHARMD
• Stacy Lynn Drasen, M.D.

• Registered Nurse in Portland, OR
• Providers in Portland, OR by specialty
• Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; 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.