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

Edgar Allan Gutierrez

Individual provider Registered Nurse · NPI 1093053449

Edgar Allan Gutierrez is a Nurse Practitioner in Portland, Oregon. Qualified in 2014, 12 years ago. Practices with Kaiser Foundation Health Plan of the Northwest, a 1,811-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
12
Licensed in
OR
In the registry since
2013
Specialties on file
2
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Practice location Address checks out

8122 SE Tibbetts St
Portland, OR 97206-1768
Phone: (503) 255-1111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 201405804NP-PP (OR)
Registered Nurse Taxonomy 163W00000X · Licence 200341187-RN (OR)

Record details

NPI number1093053449
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 18, 2013
Last updated in NPPESDecember 29, 2021
Certification dateDecember 29, 2021
Mailing address5750 Se Tranquil Ct, Milwaukie, OR 97267-4343

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Kaiser Foundation Health Plan Of The Northwest — 1811 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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