Individual provider Active NPI

Nerissa Galvez, RN

  • Addiction (Substance Use Disorder) Registered Nurse
  • Tigard, OR
National Provider Identifier
1972966646
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
201240694RN Issued in OR
Practice address
10763 SW Greenburg Rd
Ste 100
Tigard, OR 97223-5492
Phone
(503) 684-8159
NPI assigned
Mar 31, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 201240694RN OR
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 201240694RN OR Primary

Addresses

Primary practice location

10763 SW Greenburg Rd
Ste 100
Tigard, OR 97223-5492

Mailing address

10763 SW Greenburg Rd
Ste 100
Tigard, OR 97223-5492
Phone (503) 684-8159

Other identifiers 1

IdentifierTypeStateIssuer
028382MedicaidOR

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
201240694RNORMDSubstance Use Disorder Rehabilitation Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
CRC Health Oregon, LLC Past Accepting new patients
CRC Health Oregon, LLC Rehabilitation, Substance Use Disorder Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1972966646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10763 SW GREENBURG RD",
            "address_2": "STE 100",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235492",
            "telephone_number": "503-684-8159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10763 SW GREENBURG RD",
            "address_2": "STE 100",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235492",
            "telephone_number": "503-684-8159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALVEZ",
        "first_name": "NERISSA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-31",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "OR",
            "license": "201240694RN",
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "201240694RN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028382",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; 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.