Healthcare Provider Details

I. General information

NPI: 1891142410
Provider Name (Legal Business Name): MICHAEL COWLES APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2016
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19185 SW 90TH AVE
TUALATIN OR
97062-7558
US

IV. Provider business mailing address

500 NE MULTNOMAH ST FL 11
PORTLAND OR
97232-2023
US

V. Phone/Fax

Practice location:
  • Phone: 800-813-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number202101276NP-PP
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License NumberAPRN002179
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: