ANNA C LONG PMHNP NPI 1063611903

NPI Information

  • NPI: 1063611903
  • Provider Name: ANNA C LONG, PMHNP
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3633 NE 17TH AVE
    PORTLAND, OR
    ZIP 97212
  • Phone: (503) 407-3953

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NPI Details

Anna C Long, PMHNP is a psychiatric/mental health nurse practitioner in Portland, OR with 19 years of experience. Anna C Long, PMHNP NPI is 1063611903. 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:

3633 NE 17TH AVE
PORTLAND, OR
ZIP 97212-366
Phone: (503) 407-3953

The NPI 1063611903 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 7/12/2007 and was last updated on 10/16/2024.

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
1163WP0808XRegistered NursePsychiatric/Mental Health200750076NPOREGONNo
2363LP0808XNurse PractitionerPsychiatric/Mental Health200750076NPOREGONYes

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: 11/21/2025

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