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

Jolly Daniel, FNP

Individual provider Family Nurse Practitioner · NPI 1679205777

Jolly Daniel, FNP is a Nurse Practitioner in Portland, Oregon. Qualified in 2004, 22 years ago. Practices with Providence Health and Services Oregon, a 1,426-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
22
Licensed in
OR
In the registry since
2022
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

4805 NE Glisan St Ste 11N
Portland, OR 97213-2933
Phone: (503) 215-8650
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4097 Nw 176th Ave, Portland, OR 97229-3088 — (503) 784-0743

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 10031091 (OR)

Record details

NPI number1679205777
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedJune 28, 2022
Last updated in NPPESJanuary 2, 2025
Certification dateJanuary 2, 2025
Mailing addressPo Box 3158, Portland, OR 97208-3158

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Providence Health And Services Oregon — 1426 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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