ANNE WALLIS (NPI# 1396210100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396210100 |
| Entity Type | Individual |
| Full Name | ANNE WALLIS |
| Credential | RN |
| Practice Address |
13007 Ne Glisan St Portland OR 97230-2545 |
| Mailing Address |
4531 Se Belmont St Ste 100 Portland OR 97215-1675 |
| Practice Telephone | 5032157850 |
| Mailing Telephone | 5032156556 |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2018-10-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WH0200X |
Registered Nurse Specialization: Home Health |
201406034RN | OR | Nursing Service Providers |
| Street Address |
13007 NE GLISAN ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97230-2545 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497757447 | Luis Felipe Rodriguez | Internal Medicine | 13007 Ne Glisan St, Portland, OR 97230-2545 | 2005-08-10 |
| 1457995292 | Emily Ballou | Licensed Practical Nurse | 13007 Ne Glisan St, Portland, OR 97230-2545 | 2019-11-05 |
| 1407499577 | Melissa Smith | Registered Nurse | 13007 Ne Glisan St, Portland, OR 97230-2545 | 2019-10-22 |
| 1942773114 | Hannah Justine Heller | Social Worker | 13007 Ne Glisan St, Portland, OR 97230-2545 | 2019-01-09 |
| 1003397449 | Linda Marie Maier | Registered Nurse | 13007 Ne Glisan St, Portland, OR 97230-2545 | 2018-08-23 |
| 1861906497 | Venae Nolan Rodriguez | Social Worker | 13007 Ne Glisan St, Portland, OR 97230-2545 | 2017-11-17 |
| 1568973295 | Torbari Ngia Gbaanador | Registered Nurse | 13007 Ne Glisan St, Portland, OR 97230-2545 | 2017-10-20 |
| 1215470331 | Dianne Marie Denotter | Dietitian, Registered | 13007 Ne Glisan St, Portland, OR 97230-2545 | 2016-11-21 |
| 1851849368 | Cheryl Ann Roth | Physical Therapy Assistant | 13007 Ne Glisan St, Portland, OR 97230-2545 | 2016-09-13 |
| 1396193926 | Gail Buck | Licensed Practical Nurse | 13007 Ne Glisan St, Portland, OR 97230-2545 | 2016-05-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932687233 | Timisha K Wilson | Social Worker | 12505 Ne Halsey St, Portland, OR 97230 | 2018-07-30 |
| 1356828768 | Sally Gail Logan | Pharmacist | 5725 Ne 138th Avenue, Portland, OR 97230 | 2018-07-27 |
| 1063937951 | Marley Elizabeth Small | Counselor | 1507 Ne 122nd Ave., Portland, OR 97230 | 2017-08-11 |
| 1447771316 | Shadab Nasreen Aijazi | Pathology | 5220 Ne 122nd Avenue, Portland, OR 97230 | 2017-06-30 |
| 1104378199 | Derek Andrus | Pharmacist | 5717 Nw 138th, Portland, OR 97230 | 2016-10-26 |
| 1164972675 | Rachael Anderson | Adult Companion | 423 Ne 160th Ave #11, Portland, OR 97230 | 2016-10-07 |
| 1750837597 | Providence Elderplace | Assisted Living Facility | 16430 Ne Hoyt St, Portland, OR 97230 | 2016-08-31 |
| 1649622473 | Sara Mcgroarty | Counselor | 17710 Ne Halsey Street, Portland, OR 97230 | 2016-07-05 |
| 1346699949 | Steven D Stanton | Counselor | 1022 Ne 181st Ave, C1, Portland, OR 97230 | 2016-06-06 |
| 1215390091 | The Wallace Medical Concern | Clinic/Center | 18139 Ne Couch Street, Portland, OR 97230 | 2016-03-30 |
| Find all providers in zip 97230 | ||||
| Taxonomy Code | 163WH0200X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Home Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295288991 | Harvey Mccluskey | Registered Nurse | 13521 Ne Halsey St, Portland, OR 97230-3243 | 2016-07-28 |
| 1356783328 | Mercedes Siento Gonzalez | Registered Nurse | 2027 Ne Multnomah St, Portland, OR 97232-2188 | 2013-07-19 |
| 1225326002 | Charity Grace Pape | Registered Nurse | 1625 Se Bidwell St, Unit 7, Portland, OR 97202-6156 | 2011-07-14 |
| 1659666352 | Serena Lee Watson | Registered Nurse | 11824 Ne Stanton St, Portland, OR 97220-1763 | 2011-06-10 |
| 1598094583 | Shannon Marie Holyoke | Registered Nurse | 9425 N Geneva Ave, Portland, OR 97203-2648 | 2009-12-22 |
| 1750842514 | Peter Schubert Larkin | Registered Nurse | 4531 Se Belmont St Ste 100, Portland, OR 97215-1675 | 2019-03-26 |
| 1336525047 | Anna Shkurinsky | Registered Nurse | 14516 E Burnside St, Portland, OR 97233-2142 | 2015-08-04 |
| 1023497328 | Jeremy Talmadge Middleton | Registered Nurse | 420 Ne Mason St, Clinic, Portland, OR 97211-3479 | 2015-05-20 |
| 1619221389 | Marc R. Mcfarland | Registered Nurse | 4540 Ne Glisan St, Portland, OR 97213-2333 | 2012-11-02 |
| 1356691828 | Miriam Gottlieb | Registered Nurse | 4531 Se Belmont St, Ste 100, Portland, OR 97215-1675 | 2012-09-12 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.