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1609090398 NPI number — LISA RENE HODGERS BAYNE FNP

NPI Number: 1609090398
Health Care Provider/Practitioner: LISA RENE HODGERS BAYNE FNP

Information about “1609090398” NPI (LISA RENE HODGERS BAYNE FNP) exists in 1609090398 in HTML format HTML  |  1609090398 in plain Text format TXT  |  1609090398 in PDF (Portable Document Format) PDF  |  1609090398 in an XML format XML  formats.

NPI Number : 1609090398 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1609090398",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BAYNE",
    "FirstName": "LISA",
    "MiddleName": "RENE HODGERS",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "FNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "HODGERS",
    "OtherFirstName": "LISA",
    "OtherMiddleName": "RENE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "7650 SW BEVELAND RD STE 200",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PORTLAND",
    "MailingAddressStateName": "OR",
    "MailingAddressPostalCode": "97223-8692",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "503-601-3615",
    "MailingAddressFaxNumber": "503-646-1683",
    "FirstLinePracticeLocationAddress": "9701 SW BARNES RD STE 150",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PORTLAND",
    "PracticeLocationAddressStateName": "OR",
    "PracticeLocationAddressPostalCode": "97225-6689",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "503-734-3535",
    "PracticeLocationAddressFaxNumber": "503-734-3530",
    "EnumerationDate": "04/12/2007",
    "LastUpdateDate": "10/07/2025",
    "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": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "200650137NP",
        "LicenseNumberStateCode": "OR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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