TARA ERICKSEN NP NPI 1780157115

NPI Information

NPI: 1780157115
Provider Name: TARA ERICKSEN, NP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
4224 NE HALSEY ST STE 335
PORTLAND, OR
ZIP 97213
Phone: (503) 922-6616
Get Directions

Tara Ericksen, NP is a psychiatric/mental health nurse practitioner in Portland, OR with 6 years of experience. Tara Ericksen, NP NPI is 1780157115. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4224 NE HALSEY ST STE 335
PORTLAND, OR
ZIP 97213-568
Phone: (503) 922-6616

The NPI 1780157115 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/8/2019 and was last updated on 4/18/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	202105081	OREGON	Yes
2	363LW0102X	Nurse Practitioner	Women's Health	NP95010525	CALIFORNIA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	NP95010525	OTHER	CALIFORNIA	NURSE PRACTITIONER AND FURNISHING LICENSE
2	202105081	OTHER	OREGON	NURSE PRACTITIONER LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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