JUANITA TUCKER


Address: 3034 Ne M L King Blvd, Portland, OR 97212-3053
Phone: 5032833763

JUANITA TUCKER (NPI# 1114092145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1114092145
Entity Type Individual
Full Name JUANITA TUCKER
Credential QMHP
Practice Address 3034 Ne M L King Blvd
Portland
OR 97212-3053
Mailing Address 4216 Ne Rodney Ave
Portland
OR 97211-3428
Practice Telephone 5032833763
Enumeration Date 2006-11-22
Last Update Date 2012-12-21
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
Behavioral Health & Social Service Providers
Y 101YM0800X Counselor
Specialization: Mental Health
Behavioral Health & Social Service Providers
N 1041C0700X Social Worker
Specialization: Clinical
L4517 OR Behavioral Health & Social Service Providers

Other Providers JUANITA TUCKER

NPI Name Taxonomy Address Enumeration
1952933707 Juanita Tucker Behavior Technician 1408 Bailey Ave, Chattanooga, TN 37404-2903 2020-02-10

Office Location

Street Address 3034 NE M L KING BLVD
City PORTLAND
State OR
Zip Code 97212-3053

Providers in the same location

NPI Name Taxonomy Address Enumeration
1871709113 Ukana Karanei Anderson Case Manager/Care Coordinator 3034 Ne M L King Blvd, Portland, OR 97212-3053 2007-05-15
1447465166 Beryl Sylvia Mcnair Case Manager/Care Coordinator 3034 Ne M L King Blvd, Portland, OR 97212-3053 2007-05-14
1265647986 Kyle Matthew Barbisan Case Manager/Care Coordinator 3034 Ne M L King Blvd, Portland, OR 97212-3053 2007-05-14
1174738892 Alma J Brown West Case Manager/Care Coordinator 3034 Ne M L King Blvd, Portland, OR 97212-3053 2007-05-14
1932312857 Justin William Ashbridge Counselor 3034 Ne M L King Blvd, Portland, OR 97212-3053 2007-05-07
1629100797 Susan Jean Blacker Case Manager/Care Coordinator 3034 Ne M L King Blvd, Portland, OR 97212-3053 2007-03-12
1629106174 Carolyn Mounts Social Worker 3034 Ne M L King Blvd, Portland, OR 97212-3053 2007-02-28
1538208129 Cascadia Behavioral Healthcare Inc Clinic/Center 3034 Ne M L King Blvd, Portland, OR 97212-3053 2007-02-06
1023156338 Gladys M Howard Social Worker 3034 Ne M L King Blvd, Portland, OR 97212-3053 2007-02-01
1871639641 Roberta Kornblum Registered Nurse 3034 Ne M L King Blvd, Portland, OR 97212-3053 2007-01-29
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1285191361 Beliving Counseling and Consulting Counselor 311 Ne Russell Street, #211, Portland, OR 97212 2019-02-26
1497223051 Shira Dennis Behavioral Analyst 3424 Ne Tillamook St., Portland, OR 97212 2018-11-12
1659890317 Cidnee Potter Doula 2915 Ne Mlk Jr Blvd, Portland, OR 97212 2017-09-14
1588194187 Ann M Staple Counselor 2905 Ne Tillamook St, Portland, OR 97212 2017-06-15
1780129502 Noelle Denise King Naturopath 2540 Ne Martin Luther King Jr Blvd Femelle Integrative, Suite A, Portland, OR 97212 2017-01-03
1285085100 Jessica Battin Massage Therapist 2310 Ne 8th Ave #2, Portland, OR 97212 2016-06-22
1316311830 Dr Elise Schroeder Clinic/Center 3531 Ne 15th Ave Suite A, Portland, OR 97212 2015-11-20
1467820738 Ayanna Askari Counselor 3655 N E Grand Ave, Portland, OR 97212 2015-09-03
1053797167 Iliana Henriquez Social Worker 3500 Ne Martin Luther King Blvd Suite 200, Portland, OR 97212 2015-07-31
1417346834 Emily Mcdonough Comerford Case Manager/Care Coordinator 1823 Ne 8th Avenue, Kinship House, Portland, OR 97212 2015-01-22
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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1336748243 Jessica M Feinsmith Counselor 6530 N Williams Ave, Portland, OR 97217-1924 2020-10-21
1720687809 Karissa Myriah Gregory Counselor 14255 Se Rupert Dr, Portland, OR 97267-1211 2020-10-20
1528667904 Zuzana Sakova Counselor 819 Se Morrison St Ste 225, Portland, OR 97214-6311 2020-10-18
1891302238 Nina Landey Counselor 120 Se 53rd Ave, Portland, OR 97215-1204 2020-09-29
1902412166 Peter H Addy LLC Counselor 524 N Tillamook St Ste 102b, Portland, OR 97227-1993 2020-09-22
1326654765 Naomi Painter Counselor 1925 Ne 19th Ave Apt 8a, Portland, OR 97212-4526 2020-09-21
1750996104 Sara Fuller Counselor 3016 Ne 70th Ave, Portland, OR 97213-5802 2020-09-12
1114532983 Matthew W Cronin Counselor 1122 Ne 122nd Ave Ste 200, Portland, OR 97230-2081 2020-09-09
1447865381 Luke Colbourn Counselor 2705 E Burnside St Ste 206, Portland, OR 97214-1768 2020-09-08
1710599774 Abigail Kathryn Ernst Counselor 1020 Sw Taylor St # 100, Portland, OR 97205-2543 2020-08-20
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Competitor

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City PORTLAND
Zip Code 97212

Improve Information

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Dataset Information

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.

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