LIFEWORKS NORTHWEST (NPI# 1295043982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295043982 |
| Entity Type | Organization |
| Organization Name | LIFEWORKS NORTHWEST |
| Practice Address |
14600 Nw Cornell Rd Portland OR 97229-5442 |
| Practice Telephone | 5036453581 |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2010-09-16 |
| Authorized Official Name | MARY MONNAT (PRESIDENT/CEO) |
| Authorized Official Telephone | 5036453581 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500621571 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336516392 | Lifeworks Northwest | Case Management | 4941 Ne 17th Ave, Portland, OR 97211-5709 | 2015-08-26 |
| 1689812166 | Lifeworks Northwest | Community/Behavioral Health | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2009-01-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LIFEWORKS NORTHWEST | 14600 Nw Cornell Rd, Portland, OR 97229-5442 |
| Oregon Corporations, Companies and Business Names | LIFEWORKS NORTHWEST | 14600 Nw Cornell Rd, Portland, OR 97229 |
| Street Address |
14600 NW CORNELL RD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97229-5442 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467408013 | Lifeworks Nw | Counselor | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2006-05-25 |
| 1083213771 | Rebecca Saunders | Counselor | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2020-10-22 |
| 1225637986 | Nicholas David Carter | Student in an Organized Health Care Education/Training Program | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2020-10-22 |
| 1720686223 | Ruby Benner | Case Manager/Care Coordinator | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2020-10-15 |
| 1326654898 | Lindsy Jean Brownson | Student in an Organized Health Care Education/Training Program | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2020-09-21 |
| 1689280554 | Elizabeth Cady Yu Louise Handley | Student in an Organized Health Care Education/Training Program | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2020-09-16 |
| 1184238024 | Clark Hazel | Counselor | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2020-09-08 |
| 1942813704 | Juliana Marler | Student in an Organized Health Care Education/Training Program | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2020-08-30 |
| 1508479478 | Kevin I Lay | Case Manager/Care Coordinator | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2020-08-28 |
| 1144833674 | Alyssa Pataki | Student in an Organized Health Care Education/Training Program | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2020-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851919906 | Anjana Rajan | Counselor | Lifeworks Northwest, 14600 Nw Cornell Rd, Portland, OR 97229 | 2020-07-06 |
| 1871138453 | Kedrick Starr | Case Manager/Care Coordinator | 14600 Nw Cornell Rd., Portland, OR 97229 | 2019-11-07 |
| 1477102689 | Raquel A Bishop | Nurse Practitioner | 12400 Nw Cornell Rd Ste 100, Portland, OR 97229 | 2019-09-10 |
| 1669026134 | Alexandra Elizabeth Lodwig | Speech-Language Pathologist | 255 Nw Lost Springs Terrace Apt 304, Portland, OR 97229 | 2019-08-01 |
| 1003316043 | Jenny Lavonne Thom | Counselor | 15220 Nw Laidlaw Rd., Suite 280, Portland, OR 97229 | 2018-02-16 |
| 1194230664 | Ankita Guchait | Case Manager/Care Coordinator | 14600 Nw Cornell Rd, Portland, OR 97229 | 2017-12-06 |
| 1568988913 | Hannah Hendrix Klingelheber | Speech-Language Pathologist | 15605 Nw Ryegrass St., Portland, OR 97229 | 2017-08-17 |
| 1548791213 | Adeline Mitchell | Registered Nurse | 14600 Sw Cornell Rd., Portland, OR 97229 | 2017-03-24 |
| 1538610670 | Crystal Graves | Peer Specialist | 14600 Nw Cornell, Portland, OR 97229 | 2016-10-24 |
| 1639533185 | Evelin James | Dental Hygienist | 5879 Nw Lark Meadow Ter, Portland, OR 97229 | 2016-04-11 |
| Find all providers in zip 97229 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801403910 | Baseti Gelgelu | Custodial Care Facility | 2055 Sw 79th Ave, Portland, OR 97225-3805 | 2020-09-23 |
| 1801402946 | Demeti Gelgelu | Custodial Care Facility | 2010 Sw 79th Ave, Portland, OR 97225-3806 | 2020-09-22 |
| 1386122687 | Diana Elizabeth Gwinn | Custodial Care Facility | 16405 Ne Fargo Cir, Portland, OR 97230-5513 | 2018-07-30 |
| 1306212295 | Amer Filipovic | Custodial Care Facility | 2708 Se 111th Ave, Portland, OR 97266-1106 | 2015-08-14 |
| 1740410356 | Paradise Adult Foster Care Incorporated | Custodial Care Facility | 1356 Se 172nd Ave, Portland, OR 97233-4702 | 2009-07-16 |
| 1013153659 | Ileana Kerezsi | Custodial Care Facility | 3519 Se Cora Dr, Portland, OR 97202-3332 | 2009-01-04 |
| 1639291131 | Casa, Inc | Custodial Care Facility | 741 Warren Ave, Portland, ME 04103-1007 | 2007-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447808100 | Remelita Loftin | Custodial Care Facility | 2297 Minnesota St, Eugene, OR 97402-6244 | 2019-08-27 |
| 1316506397 | Stephenie Jo Murdock | Custodial Care Facility | 2355 Baker St, Baker City, OR 97814-2541 | 2019-06-12 |
| 1346707296 | Dastu I Ahmat | Custodial Care Facility | 55 Nw 23rd St, Gresham, OR 97030-2640 | 2019-02-27 |
| 1558837781 | Larisa Kravchuk | Custodial Care Facility | 805 Fir Cone Dr Ne, Keizer, OR 97303-4328 | 2018-10-15 |
| 1376071464 | Mckenzie Living, Incorporated | Custodial Care Facility | 2621 Lone Oak Way, Eugene, OR 97404 | 2017-06-01 |
| 1598292997 | Gateway Assisted Living, Inc. | Custodial Care Facility | 611 N Cloverleaf Loop, Springfield, OR 97477-1188 | 2017-05-16 |
| 1841727617 | Gateway Gardens Assisted Living, Inc. | Custodial Care Facility | 178 Commons Dr, Eugene, OR 97401-8923 | 2017-05-11 |
| 1609314509 | Catherine Jensens Foster Home | Custodial Care Facility | 108 Ash Drive, Rogue River, OR 97537 | 2017-02-10 |
| 1932647211 | Lynn Marie Bartlett | Custodial Care Facility | 4286 Camellia Dr S, Salem, OR 97302-2710 | 2017-02-07 |
| 1568906477 | Radiant Care Afh 'llc' | Custodial Care Facility | 52 Nw Birch Ct, Warrenton, OR 97146 | 2016-12-12 |
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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.