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1144009119 NPI number — MELISSA PORTNOY ARNP

NPI Number: 1144009119
Health Care Provider/Practitioner: MELISSA PORTNOY ARNP

Information about “1144009119” NPI (MELISSA PORTNOY ARNP) exists in 1144009119 in HTML format HTML  |  1144009119 in plain Text format TXT  |  1144009119 in PDF (Portable Document Format) PDF  |  1144009119 in an XML format XML  formats.

NPI Number : 1144009119 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1144009119",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PORTNOY",
    "FirstName": "MELISSA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "ARNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ESTRADA-ELENA",
    "OtherFirstName": "MELISSA",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "ARNP",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "530 BOGACHIEL WAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FORKS",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98331-9120",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "360-374-6271",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "390 FOUNDERS WAY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FORKS",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98331-9062",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "360-374-6998",
    "PracticeLocationAddressFaxNumber": "360-374-3162",
    "EnumerationDate": "09/27/2023",
    "LastUpdateDate": "11/02/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "163WE0003X",
          "TaxonomyName": "Emergency Registered Nurse",
          "LicenseNumber": "RN60565637",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "AP61499144",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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