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

Glen Martin Cunningham, FNP

Individual provider Family Nurse Practitioner · NPI 1871450460

Glen Martin Cunningham, FNP is a Nurse Practitioner in Portland, Oregon. Qualified in 2025, 1 year ago. Practices with Fanno Creek Clinic LLC, a 24-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
1
Licensed in
OR
In the registry since
2026
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

2400 SW Vermont St
Portland, OR 97219-1940
Phone: (503) 452-0915
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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 10055208 (OR)

Record details

NPI number1871450460
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP
Sole proprietorNo
NPI enumeratedJanuary 6, 2026
Last updated in NPPESJanuary 6, 2026
Certification dateJanuary 6, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Fanno Creek Clinic Llc — 24 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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