Provider Demographics
NPI:1902606486
Name:OWEN, DANE PATRICK (RN)
Entity type:Individual
Prefix:
First Name:DANE
Middle Name:PATRICK
Last Name:OWEN
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9822 N MACRUM AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203-1822
Mailing Address - Country:US
Mailing Address - Phone:808-385-7021
Mailing Address - Fax:
Practice Address - Street 1:9822 N MACRUM AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203-1822
Practice Address - Country:US
Practice Address - Phone:808-385-7021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-14
Last Update Date:2025-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201806253RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse