NW INSITUTO LATINO (NPI# 1114546645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114546645 |
| Entity Type | Organization |
| Organization Name | NW INSITUTO LATINO |
| Practice Address |
2054 N Vancouver Ave Portland OR 97227-1917 |
| Mailing Address |
775 Ne 9th St Gresham OR 97030-5668 |
| Practice Telephone | 5038883464 |
| Mailing Telephone | 5038883464 |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |
| Authorized Official Name | MIGUEL TELLEZ (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5038883464 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Street Address |
2054 N VANCOUVER AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97227-1917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114118049 | Wendell Coxeff | Counselor | 2054 N Vancouver Ave, Portland, OR 97227-1917 | 2007-08-06 |
| 1760850549 | Michael David Razavi | Counselor | 2054 N Vancouver Ave, Portland, OR 97227-1917 | 2015-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466574 | Jessica Michelle Simonetti | Psychologist | Portland Psychotherapy Clinic, Research and Training Ce, 3700 N Williams Ave, Portland, OR 97227 | 2020-10-29 |
| 1447812268 | Maksim Yefimov | Physician Assistant | 2800 N Vancouver Ave Ste 130, Portland, OR 97227 | 2019-07-01 |
| 1851955975 | Erin Marie Staples | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave;, Suite 230, Portland, OR 97227 | 2019-04-24 |
| 1922588508 | Melanie Grace Mix | Physician Assistant | 501 N Graham St Ste 420, Portland, OR 97227 | 2018-08-14 |
| 1730615071 | Mehran Giblin | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave, Suite 230, Legacy Clinic Emanuel, Portland, OR 97227 | 2017-05-05 |
| 1730623687 | Christina Grace Belter | Optometrist | 300 N Graham St Ste 300, Portland, OR 97227 | 2016-12-12 |
| 1407300205 | Jenna Abernathy | Counselor | 3537 N Williams Ave, Portland, OR 97227 | 2016-08-09 |
| 1215390760 | Tanya Marie Woods | Massage Therapist | 3808 N. Williams Ave., Portland, OR 97227 | 2016-04-01 |
| 1033596853 | Eric Allen Martin | Counselor | 2054 N. Vancouver Ave, Portland, OR 97227 | 2015-04-30 |
| 1285040436 | Berk Neurosurgical LLC | Neurological Surgery | 501 N Graham St Ste 500, Portland, OR 97227 | 2014-07-09 |
| Find all providers in zip 97227 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477002228 | Treehouse Nw Inc | Substance Abuse Rehabilitation Facility | 4713 N Albina Ave, Suite 301, Portland, OR 97217-2605 | 2016-09-21 |
| 1154785475 | Blvd Centers, Inc | Substance Abuse Rehabilitation Facility | 1316 Se 12th Ave, Portland, OR 97214-3604 | 2016-04-12 |
| 1104219211 | Allied Health Services | Substance Abuse Rehabilitation Facility | 808 Se Alder St, Portland, OR 97214-2213 | 2015-03-13 |
| 1700297074 | Pathfinders of Oregon | Substance Abuse Rehabilitation Facility | 7800 Sw Barbur Blvd, Portland, OR 97219-2823 | 2014-05-08 |
| 1194037283 | De Paul Treatment Centers | Substance Abuse Rehabilitation Facility | 1312 Sw Washington St., Portland, OR 97208 | 2010-07-06 |
| 1649412511 | Portland Detox | Substance Abuse Rehabilitation Facility | 11160 Sw Waverly Pl, Portland, OR 97225-4456 | 2009-03-24 |
| 1144432907 | Serenity House, Inc. | Substance Abuse Rehabilitation Facility | 30 Mellen St, Portland, ME 04101-2110 | 2007-05-04 |
| 1063548436 | Milestone Foundation Inc | Substance Abuse Rehabilitation Facility | 65 India St, Portland, ME 04101-4209 | 2007-02-27 |
| 1851428775 | Depaul Treatment Centers Inc. | Substance Abuse Rehabilitation Facility | 5052 Ne 42nd Ave, Portland, OR 97218-1550 | 2007-02-27 |
| 1730673088 | Pine Tree Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 17 Bishop St, Portland, ME 04103-2659 | 2018-06-20 |
| 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.