Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Angela Massoni-Blaine

Individual provider Adult Health Nurse Practitioner · NPI 1043649908

Angela Massoni-Blaine is a Nurse Practitioner in Portland, Oregon. Qualified in 2013, 13 years ago. Practices with Legacy Clinics LLC, a 718-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California and Oregon.

Years since qualifying
13
Licensed in
CA, OR
In the registry since
2013
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2222 NW Lovejoy St
Portland, OR 97210-3033
Phone: (503) 413-8036
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1220 12th St Se, Washington, DC 20003-3722 — (202) 715-7900

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 201910414NP-PP (OR)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence 23638 (CA)

Record details

NPI number1043649908
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 1, 2013
Last updated in NPPESAugust 26, 2020
Certification dateAugust 26, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Legacy Clinics Llc — 718 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Portland