OWEN WALLULATUM (NPI# 1265966055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265966055 |
| Entity Type | Individual |
| Full Name | OWEN WALLULATUM |
| Credential | CRM |
| Practice Address |
340 Nw 5th St Box 1710 Redmond OR 97756-1869 |
| Mailing Address |
850 Sw 4th St Madras OR 97741-9628 |
| Practice Telephone | 5415164087 |
| Practice Fax Number | 5415041195 |
| Mailing Telephone | 5414754822 |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2017-04-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
17 CRM 065 | OR | Behavioral Health & Social Service Providers |
| Street Address |
340 NW 5TH ST BOX 1710 |
| City | REDMOND |
| State | OR |
| Zip Code | 97756-1869 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073590683 | Amy B Mcelroy | Nurse Practitioner | 340 Nw 5th St, Suite 101, Redmond, OR 97756-1869 | 2005-12-23 |
| 1073049128 | Denise Piza | Counselor | 340 Nw 5th St, Box 1710, Redmond, OR 97756-1869 | 2017-05-11 |
| 1467988345 | Scott Stacey | Counselor | 340 Nw 5th St, Box 1710, Redmond, OR 97756-1869 | 2017-05-11 |
| 1053842690 | Stacy Jim | Counselor | 340 Nw 5th St, Box 1710, Redmond, OR 97756-1869 | 2017-03-24 |
| 1629517479 | Laura Hendrix | Counselor | 340 Nw 5th St, Box 1710, Redmond, OR 97756-1869 | 2017-02-13 |
| 1326400151 | Laurie Doyon | Obstetrics & Gynecology | 340 Nw 5th St, Redmond, OR 97756-1869 | 2016-03-22 |
| 1821459439 | Emily Hollenbeak | Counselor | 340 Nw 5th St, Box 1710, Redmond, OR 97756-1869 | 2016-03-09 |
| 1366801151 | Amber Paplia | Counselor | 340 Nw 5th St, Box 1710, Redmond, OR 97756-1869 | 2016-02-22 |
| 1114386000 | Levy Newton | Nurse's Aide | 340 Nw 5th St, Box 1710, Redmond, OR 97756-1869 | 2016-02-19 |
| 1700242328 | Robert Snyder | Counselor | 340 Nw 5th St, Box 1710, Redmond, OR 97756-1869 | 2016-01-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679083349 | Vicki Rae Morris | Foster Care Agency | 3585 Sw 35th St., Redmond, OR 97756 | 2017-10-06 |
| 1275066417 | Norco, Inc | Durable Medical Equipment & Medical Supplies | 655 Nw Jackpine Ave, Redmond, OR 97756 | 2017-04-05 |
| 1750778015 | Kelly Gobler | Occupational Therapy Assistant | 3000 Sw 32nd Street, The Heights Assisted Living, Redmond, OR 97756 | 2015-04-23 |
| 1912303934 | Andrea Adams | Pharmacist | 944 Sw Veterans Way, Redmond, OR 97756 | 2014-11-18 |
| 1649670365 | Advantage Dental Clinics LLC | Dentist | 442 Sw Umatilla Ave., Suite 200, Redmond, OR 97756 | 2014-08-29 |
| 1760891832 | Elizabeth Mae Smith | Counselor | 2659 Sw 4th St Ste 102, Redmond, OR 97756 | 2014-08-04 |
| 1700296837 | Heather A Ahlf | Physician Assistant | 1245 Nw Canal Blvd, Redmond, OR 97756 | 2014-04-29 |
| 1306289277 | Asa Racquel Aramburo | Social Worker | 203 Sw 8th St., Redmond, OR 97756 | 2013-04-10 |
| 1427396969 | Alison Elizabeth Jackson | Pharmacist | 944 Sw 9th Street, Redmond, OR 97756 | 2013-01-17 |
| 1083964449 | Julie C Plachta | Mechanotherapist | 654 Nw 4th Street, Redmond, OR 97756 | 2012-09-13 |
| Find all providers in zip 97756 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861959462 | Bret N Stern | Counselor | 16225 Ne 87th St Ste A1, Redmond, WA 98052-3536 | 2019-03-01 |
| 1528557212 | Aaron Myers | Counselor | 340 Nw 5th St Ste 203, Redmond, OR 97756-1869 | 2018-05-08 |
| 1871003020 | Katelyn Lanae Olden Lindstrom | Counselor | 16345 Ne 87th St # A-6, Redmond, WA 98052-3503 | 2017-10-02 |
| 1194277962 | Eveangela Ortencia Ahmed | Counselor | 737 Sw Cascade Ave, Redmond, OR 97756-2221 | 2016-10-27 |
| 1164891891 | Kathline Benitez | Counselor | 340 Nw 5th St Ste 202, Box 1710, Redmond, OR 97756-1869 | 2015-09-23 |
| 1023353141 | Tomomi Ito | Counselor | 7981 168th Ave Ne Ste 138, Redmond, WA 98052-0911 | 2012-11-29 |
| 1366713075 | Matthew Vinson | Counselor | 1009 Nw Spruce Ave, Redmond, OR 97756-1212 | 2012-01-26 |
| 1104027432 | Sidney Chichester | Counselor | 1514 Sw Highland Ave, Redmond, OR 97756-2500 | 2007-05-31 |
| 1487791620 | Heidi R. Howard | Counselor | 2410 Quail Creek Way Ne, Redmond, WA 98053-3114 | 2007-01-30 |
| 1134283971 | Thomas&thomas Enterprises, Inc. | Counselor | 16310 Ne 80th St, Suite 104, Redmond, WA 98052-3861 | 2006-12-19 |
| Find all providers in REDMOND | ||||
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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.