TRACEY DIONA AMLIN FNP NPI 1659653277

NPI Information

NPI: 1659653277
Provider Name: TRACEY DIONA AMLIN, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
4340 N INTERSTATE AVE
PORTLAND, OR
ZIP 97217
Phone: (503) 215-1444
Get Directions

Tracey Diona Amlin, FNP is a family nurse practitioner in Portland, OR. Tracey Diona Amlin, FNP NPI is 1659653277. 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:

4340 N INTERSTATE AVE
PORTLAND, OR
ZIP 97217-211
Phone: (503) 215-1444

The enumeration date for this NPI number is 9/10/2011 and was last updated on 7/21/2016.

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	363LF0000X	Nurse Practitioner	Family	12645NP	OHIO	No
2	363LF0000X	Nurse Practitioner	Family	AP60645755	WASHINGTON	No
3	363LF0000X	Nurse Practitioner	Family	201505843NP-PP	OREGON	Yes

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
1	R186583	MEDICARE PIN	OREGON
2	R187454	MEDICARE PIN	OREGON
3	R188372	MEDICARE PIN	OREGON
4	G8953141	MEDICARE PIN	WASHINGTON
5	R187451	MEDICARE PIN	OREGON
6	R187453	MEDICARE PIN	OREGON
7	500699841	MEDICAID	OREGON
8	R187452	MEDICARE PIN	OREGON

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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