Nicole C Tabbal, AGACNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

201906846NP-PP Issued in OR

Practice address

9427 SW Barnes Rd Ste 495
Portland, OR 97225-6612

Phone

(503) 962-1000

Fax

(503) 216-0950

NPI assigned

Aug 7, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Oregon Vascular Specialists LLCGroup PAC ID 8022386663, 11 clinicians

Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
• Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
• Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038
• Providence Milwaukie Hospital Hospital, Milwaukie, OR, CCN 380082
• Providence Seaside Hospital Hospital, Seaside, OR, CCN 381303

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ntabbal111725@oc.providencedirect.org
• FHIR API: https://fhir4.healow.com/fhir/r4/EDIHDD

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.

• Oregon Vascular Specialists LLC

  • Vascular Surgery Physician
  • Bend, OR
  • NPI 1669917167

  OR

  Medicare reassignment Care Compare group NPD
• Providence Health & Services Oregon

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343

  OR

  Medicare reassignment Care Compare group
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845

  OR

  Medicare reassignment NPD
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971

  OR

  Medicare reassignment NPD
• Providence Health & Services - Oregon

  • Clinical Pathology Physician
  • Portland, OR
  • NPI 1831641745
  NPD
• Providence Health & Services Oregon

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Portland, OR
  • NPI 1396818993
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845

  Hospital

  Care Compare affiliation
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971

  Hospital

  Care Compare affiliation
• Providence Health & Services - Oregon

  • Clinic/Center
  • Portland, OR
  • NPI 1326272741

  Hospital

  Care Compare affiliation
• Providence Health & Services - Oregon

  • Case Manager/Care Coordinator
  • Portland, OR
  • NPI 1891822995

  Hospital

  Care Compare affiliation
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Oregon City, OR
  • NPI 1912282369

  Hospital

  Care Compare affiliation
• Providence Health & Services Oregon

  • General Acute Care Hospital
  • Milwaukie, OR
  • NPI 1366536963

  Hospital

  Care Compare affiliation
• Providence Health & Services Oregon

  • Critical Access Hospital
  • Seaside, OR
  • NPI 1578500492

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1992350854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9427 SW BARNES RD STE 495",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256612",
            "telephone_number": "503-962-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9427 SW BARNES RD STE 495",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256612",
            "telephone_number": "503-962-1000",
            "fax_number": "503-216-0950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25030 SW Parkway Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Wilsonville",
            "state": "OR",
            "postal_code": "970709816",
            "country_code": "US",
            "telephone_number": "971-434-0080",
            "fax_number": "503-946-3891",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4400 NE Halsey St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972131545",
            "country_code": "US",
            "telephone_number": "503-216-0990",
            "fax_number": "503-962-1021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TABBAL",
        "first_name": "NICOLE",
        "middle_name": "C",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "201906846NP-PP",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OR",
            "license": "201906846NP-PP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ntabbal111725@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5050 NE Hoyt St Ste 511",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132984",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ntabbal111725@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9427 SW Barnes Rd Ste 495",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karen Ta, M.D.
• The Ta
• Anne Joyce Tabachnick
• Yedidya Tabanpour, ACUPUNCTURIST
• John Philip Tabb
• Wendie Lee Taber, CADC II
• Tabor Pediatric Physical Therapy LLC
• Tabor View Health and Wellness
• Katherine Ann Tacker, M.D.
• Camille Tackett, PHARMD.

• Gerontology Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Gerontology Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.