HOLLY A FAY


Address: 12360 E Burnside St, Portland, OR 97233-1042
Phone: 9712794800

HOLLY A FAY (NPI# 1932756707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1932756707
Entity Type Individual
Full Name HOLLY A FAY
Credential NP
Practice Address 12360 E Burnside St
Portland
OR 97233-1042
Mailing Address 1776 Sw Madison St
Portland
OR 97205-1715
Practice Telephone 9712794800
Practice Fax Number 9712792051
Mailing Telephone 5032241044
Mailing Fax Number 5036212235
Enumeration Date 2019-08-26
Last Update Date 2019-09-12
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse 200840955RN OR Nursing Service Providers
N 363L00000X Nurse Practitioner 201908142NP-PP OR Physician Assistants & Advanced Practice Nursing Providers
Y 363LF0000X Nurse Practitioner
Specialization: Family
201908142NP-PP OR Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
15 N Morris St, Portland, OR 972271541 5032309875 5032309877

Other Providers HOLLY FAY

NPI Name Taxonomy Address Enumeration
1699043075 Holly Kristine Fay Social Worker 430 F St, Chula Vista, CA 91910-3711 2011-12-13

Office Location

Street Address 12360 E BURNSIDE ST
City PORTLAND
State OR
Zip Code 97233-1042

Providers in the same location

NPI Name Taxonomy Address Enumeration
1508856188 Artice E Geary Social Worker 12360 E Burnside St, Portland, OR 97233-1042 2005-10-25
1487262937 Erica P Woody Counselor 12360 E Burnside St, Portland, OR 97233-1042 2020-07-21
1609416155 Cara A Koch Counselor 12360 E Burnside St, Portland, OR 97233-1042 2020-01-13
1245878552 Janelle M Bombara Dietitian, Registered 12360 E Burnside St, Portland, OR 97233-1042 2019-12-17
1013570548 Christa R Andreasen Registered Nurse 12360 E Burnside St, Portland, OR 97233-1042 2019-04-19
1679046965 Emerson N Begay Pharmacy Technician 12360 E Burnside St, Portland, OR 97233-1042 2019-01-09
1215429394 Phillip C Lacy Pharmacy Technician 12360 E Burnside St, Portland, OR 97233-1042 2018-06-04
1992205223 Sarah E Bruno Social Worker 12360 E Burnside St, Portland, OR 97233-1042 2018-02-13
1093233868 Sarah S Rivera Peer Specialist 12360 E Burnside St, Portland, OR 97233-1042 2017-08-31
1689114928 Cathy C Harrison Registered Nurse 12360 E Burnside St, Portland, OR 97233-1042 2017-03-06
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1205448164 Moore Therapy Services, LLC Behavioral Analyst 2053 Se 181st Ave, Portland, OR 97233 2020-08-20
1427563733 Central City Concern Inc Clinic/Center 1415 Se 122nd Ave, Portland, OR 97233 2017-12-08
1427573443 Sunshine Ahc In Home Supportive Care 2217 Se 156th Ave, Portland, OR 97233 2017-08-10
1538609433 Nathaniel Davis Jr. Counselor 8915 Se Center St, Tigard, OR 97233 2017-02-27
1154878627 Oregon Outreach Inc Case Management 1740 South East 139th Avenue, Portland, OR 97233 2016-09-01
1023461019 Julianne Baltzley Counselor 2409 Se 149th Avenue, Portland, OR 97233 2016-07-14
1710332143 Emma Slater Counselor 12360 Se Burnside, Portland, OR 97233 2016-05-04
1245621952 Gregory Brett Bledsoe Counselor 1427 Se 182nd Ave., Portland, OR 97233 2015-02-17
1396149852 Jacqueline Bension Counselor 1705 Se 122nd Ave, Portland, OR 97233 2014-10-13
1700206950 Olga I Zlatova I Dental Hygienist 325 Se 154th Ave, Portland, OR 97233 2014-04-25
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1043822794 Danielle Langer Nurse Practitioner 35 Ridgeview Rd, Portland, CT 06480-4014 2020-08-23
1508476250 Harrington Health Clinic Nurse Practitioner 310 Nw Glisan Street, Portland, OR 97209 2020-08-07
1114566650 Sadie Garnache-poirier Nurse Practitioner 65 W Commercial St Ste 107, Portland, ME 04101-4789 2020-01-02
1902441629 Jennifer Marie Colpitts Nurse Practitioner 1600 Congress St Ste B, Portland, ME 04102-2148 2019-11-18
1477102689 Raquel A Bishop Nurse Practitioner 12400 Nw Cornell Rd Ste 100, Portland, OR 97229 2019-09-10
1265081640 Christina Lee Nurse Practitioner 144 State St # 1, Portland, ME 04101-3776 2019-09-09
1407401474 Abby Christine Vopal Nurse Practitioner 66 Bramhall St Fl 1, Portland, ME 04102-3355 2019-08-07
1770145294 Cynthia Marie Martinez Nurse Practitioner 1145 Austin St, Portland, TX 78374-2013 2019-07-04
1528532306 Matthew James Keelin Nurse Practitioner 6801 Ne Cornfoot Rd, Portland, OR 97218-2743 2019-01-15
1659847580 Colleen Jeanette Scott Nurse Practitioner 650 Nw Irving St, Portland, OR 97209-1272 2018-10-18
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Competitor

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City PORTLAND
Zip Code 97233

Improve Information

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Dataset Information

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.

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