Healthcare Provider Details

I. General information

NPI: 1114666385
Provider Name (Legal Business Name): CHRISTOPHER ALAN RICE APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2022
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3181 SW SAM JACKSON PARK RD
PORTLAND OR
97239-3011
US

IV. Provider business mailing address

3181 SW SAM JACKSON PARK RD SJH-2
PORTLAND OR
97239
US

V. Phone/Fax

Practice location:
  • Phone: 503-494-8182
  • Fax: 503-494-0028
Mailing address:
  • Phone:
  • Fax: 503-346-8021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number10059094
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number278805
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: