Individual provider · Type 1 NPI

Staci Colovos, ACNP

Acute Care Nurse Practitioner · Portland, OR

NPI number 1366786261 Active

Practice location

3303 S Bond Ave
Portland, OR 97239-4501

Fax (503) 346-6961

Mailing address

1400 SW 5th Ave Ste 500
Portland, OR 97201-5537

Other practice locations

  • 4401 Harrison Blvd, Ogden, UT 84403 · (801) 627-2800

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner 363L00000X201403204NP-PP (OR)
Acute Care Nurse Practitioner 363LA2100X6527571-4405 (UT)
Acute Care Nurse Practitioner Primary 363LA2100X201403204NP-PP (OR)

Acute Care Nurse Practitioner: Definition to come...

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About NPI 1366786261

Staci Colovos, ACNP's National Provider Identifier is 1366786261, issued on Nov 15, 2012. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Portland, OR. The record was last updated on Aug 27, 2025.