SORREL JOHNSON (NPI# 1093337271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093337271 |
| Entity Type | Individual |
| Full Name | SORREL JOHNSON |
| Practice Address |
2375 Nw Glisan St Portland OR 97210-3420 |
| Mailing Address |
Po Box 8459 Portland OR 97207-8459 |
| Practice Telephone | 5037195209 |
| Mailing Telephone | 5032380769 |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2020-05-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 372600000X | Adult Companion | Nursing Service Related Providers |
| Street Address |
2375 NW GLISAN ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97210-3420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568549855 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 2375 Nw Glisan St, Portland, OR 97210-3420 | 2006-11-01 |
| 1275131922 | Elizabeth Rose Anderson | Technician | 2375 Nw Glisan St, Portland, OR 97210-3420 | 2020-10-14 |
| 1487269429 | Amanda Macy Vanwagenen | Case Manager/Care Coordinator | 2375 Nw Glisan St, Portland, OR 97210-3420 | 2020-09-15 |
| 1730703232 | Danielle K Cortes | Case Manager/Care Coordinator | 2375 Nw Glisan St, Portland, OR 97210-3420 | 2020-06-01 |
| 1124641733 | Heidi M Endres | Adult Companion | 2375 Nw Glisan St, Portland, OR 97210-3420 | 2020-05-19 |
| 1144842121 | Roxanne M Muhammad | Adult Companion | 2375 Nw Glisan St, Portland, OR 97210-3420 | 2020-05-12 |
| 1336769124 | Seth L Williams | Adult Companion | 2375 Nw Glisan St, Portland, OR 97210-3420 | 2020-04-21 |
| 1215557095 | Melody Kaye Johnson | Adult Companion | 2375 Nw Glisan St, Portland, OR 97210-3420 | 2020-04-21 |
| 1528687266 | John Kuwaye | Adult Companion | 2375 Nw Glisan St, Portland, OR 97210-3420 | 2020-04-13 |
| 1033743364 | In Su Jeoung | Adult Companion | 2375 Nw Glisan St, Portland, OR 97210-3420 | 2020-02-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679109086 | Joseph Francolino | Massage Therapist | 2174 Nw Davis Street, Apartment 105, Portland, OR 97210 | 2020-03-17 |
| 1215574058 | Northwest Dbt LLC | Psychologist | 2230 Nw Pettygrove St., Suite 130, Portland, OR 97210 | 2019-11-27 |
| 1649769480 | Dipesh Patel | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Ave. Legacy Clinic Good Samaritan, Portland, OR 97210 | 2018-05-08 |
| 1760987234 | Meghan Teague | Student in an Organized Health Care Education/Training Program | Legacy Good Samaritan Medical Center- Gme, 1015 Nw 22nd Ave, Portland, OR 97210 | 2018-03-27 |
| 1205349172 | Paul M Storm | Acupuncturist | 1708 Nw 25th Ave. Apt. #6, Portland, OR 97210 | 2017-11-14 |
| 1740703750 | Audra K Berning | Massage Therapist | 2122 Nw Quimby, Root Whole Body, Portland, OR 97210 | 2017-07-21 |
| 1720539810 | Anna-marie Elizabeth Wood | Audiologist | 2222 Nw Lovejoy St Ste 662, Portland, OR 97210 | 2016-10-24 |
| 1659829836 | H&s Pearl, LLC | Massage Therapist | 25 Nw 23rd Pl, Suite 7, Portland, OR 97210 | 2016-09-15 |
| 1255785796 | Cortez Natural Medicine, Inc. | Acupuncturist | 2230 Nw Pettygove Street, Unit 130, Portland, OR 97210 | 2016-04-21 |
| 1932563616 | Vincent Chen | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Avenue, Legacy Clinic Good Samaritan, Portland, OR 97210 | 2016-04-08 |
| Find all providers in zip 97210 | ||||
| Taxonomy Code | 372600000X |
| Grouping | Nursing Service Related Providers |
| Classification | Adult Companion |
| An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184271462 | Taylor Salter | Adult Companion | 7018 N Armour St, Portland, OR 97203-6132 | 2019-08-21 |
| 1235785429 | Lonzall Tatum | Adult Companion | 1212 Sw Clay St Apt 409, Portland, OR 97201-7822 | 2019-08-13 |
| 1205303021 | Imani Anderson | Adult Companion | 434 Ne Roselawn St, Portland, OR 97211-3826 | 2018-10-30 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1104364900 | Rosanna Hunnicutt | Adult Companion | 2601 Se 160th Ave, Portland, OR 97236-2092 | 2017-02-01 |
| 1043755028 | Raolat Ajibade IIi | Adult Companion | 847 N.e 19thave, Portland, OR 97232 | 2016-12-29 |
| 1164972675 | Rachael Anderson | Adult Companion | 423 Ne 160th Ave #11, Portland, OR 97230 | 2016-10-07 |
| 1255789731 | Sherri Schroeder | Adult Companion | 847 Ne 19th Ave., Suite100, Portland, OR 97232 | 2016-05-25 |
| 1750740577 | Sheila Amoo | Adult Companion | 236 N Killingworth St. Apt.b104, Portland, OR 97217 | 2016-02-22 |
| 1609241371 | Denise Broom | Adult Companion | 25 Ne Stafford St, Portland, OR 97211-2241 | 2015-12-07 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.