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PORTLAND WELLNESS PROJECT LLC
NPI 1639964828
Nurse Practitioner - Primary Care in Portland, OR

Active since April 10, 2025
1901 N KILLINGSWORTH ST, PORTLAND, OR 97217(503) 770-0670(833) 450-6082 Get Directions Write a Review

NPPES record last updated: October 14, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Portland Wellness Project Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PORTLAND WELLNESS PROJECT LLC (NPI 1639964828), doing business as Open Wellness, is a healthcare organization registered as a primary care in Portland, Oregon and active in the NPI registry since April 2025. The organization lists Ilana Gurevich, Owner, as its authorized official.

NPPES Registry Identity

NPI1639964828
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NamePORTLAND WELLNESS PROJECT LLC
Location Address1901 N KILLINGSWORTH STPortland, OR 97217-4436
Mailing Address1901 N Killingsworth StPortland, OR 97217-4436 · (503) 770-0670
Phone(503) 770-0670
Fax(833) 450-6082
Organization SubpartNo
Authorized OfficialIlana GurevichOwner · (503) 701-8766
Enumeration DateApril 10, 2025
Last NPPES UpdateOctober 14, 2025
NPPES CertifiedOctober 14, 2025
✔ NPI 1639964828 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
1901 N KILLINGSWORTH ST, Portland, OR 97217
Open in Google Maps ↗

Other Names 1

Doing Business AsOpen Wellness

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Portland Wellness Project Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Portland Wellness Project LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Erica Simonich, WHNP
Nurse Practitioner
NPI 1396083242
1901 N KILLINGSWORTH ST
Portland, OR 97217
(503) 770-0670
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Portland Wellness Project LLC's NPI number?

The NPI number for Portland Wellness Project LLC is 1639964828. It was assigned to this organization in the NPPES registry on April 10, 2025. The provider is doing business as Open Wellness.

Where is Portland Wellness Project LLC located?

Portland Wellness Project LLC is located at 1901 N Killingsworth St, Portland, OR 97217. The listed phone number is (503) 770-0670.

What is Portland Wellness Project LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Portland Wellness Project LLC enrolled in Medicare?

Yes. Portland Wellness Project LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Portland Wellness Project LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Portland Wellness Project LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Portland Wellness Project LLC was last updated on October 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.