DIANA RAQUEL INTHAVONG (NPI# 1346719317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346719317 |
| Entity Type | Individual |
| Full Name | DIANA RAQUEL INTHAVONG |
| Practice Address |
702 Sunset Dr Ontario OR 97914-3121 |
| Practice Telephone | 5418899167 |
| Practice Fax Number | 5418897873 |
| Mailing Telephone | 5418899167 |
| Mailing Fax Number | 5418897873 |
| Enumeration Date | 2018-11-19 |
| Last Update Date | 2020-05-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
702 SUNSET DR |
| City | ONTARIO |
| State | OR |
| Zip Code | 97914-3121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821056391 | Judith Poirot | Social Worker | 702 Sunset Dr, Ontario, OR 97914-3121 | 2006-05-03 |
| 1235740994 | Kristie Marlene Lyman | Counselor | 702 Sunset Dr, Ontario, OR 97914-3121 | 2020-08-14 |
| 1083225411 | Hannah Layne Radford | Social Worker | 702 Sunset Dr, Ontario, OR 97914-3121 | 2020-08-10 |
| 1902424724 | Nathan Douglas Barraza | Counselor | 702 Sunset Dr, Ontario, OR 97914-3121 | 2020-07-08 |
| 1225656036 | Denys Roy Fuhrmann | Counselor | 702 Sunset Dr, Ontario, OR 97914-3121 | 2020-07-08 |
| 1750907689 | Tamara Kay Ashley | Case Manager/Care Coordinator | 702 Sunset Dr, Ontario, OR 97914-3121 | 2020-06-16 |
| 1104440023 | Leah Dredge | Social Worker | 702 Sunset Dr, Ontario, OR 97914-3121 | 2020-06-05 |
| 1659994176 | Samuel Galan | Counselor | 702 Sunset Dr, Ontario, OR 97914-3121 | 2020-05-19 |
| 1548882434 | James E Burmeister | Case Manager/Care Coordinator | 702 Sunset Dr, Ontario, OR 97914-3121 | 2020-05-13 |
| 1619509247 | Betty Raynor | Counselor | 702 Sunset Dr, Ontario, OR 97914-3121 | 2020-02-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467925420 | The Family Place D/b/a Tfp Services Therapeutic | Case Manager/Care Coordinator | 390 Ne 2nd St., Ontario, OR 97914 | 2019-01-02 |
| 1154805729 | Ronald William Strohmeyer | Physician Assistant | 2327 S.w. 4th Ave, Ontario, OR 97914 | 2018-09-19 |
| 1700334117 | Arlene Schwenke | Social Worker | 686 Nw 9th St., Ontario, OR 97914 | 2016-09-14 |
| 1871990408 | Sally Melissa Sluder | Nurse Practitioner | 351 Sw 9th Ave, Ontario, OR 97914 | 2014-11-25 |
| 1932460870 | E Patricia Jeanne Engel | Surgery | 1050 Sw 3rd Ave Ste 2600, Ontario, OR 97914 | 2012-06-07 |
| 1487946521 | Tyler Jepson | Physical Therapist | 1182 Sw 4th Avenue, Ontario, OR 97914 | 2011-05-09 |
| 1255641577 | Cami Lyn Rebmann | Pharmacist | 728 S 4th Ave, Ontario, OR 97914 | 2010-10-20 |
| 1295051126 | Project Dove | Case Manager/Care Coordinator | 915-02 Sw 2nd Ave, Ontario, OR 97914 | 2010-04-16 |
| 1467666024 | Tfp Therapeutic Service, Inc. | Counselor | 390 Ne 2nd Street, Ontario, OR 97914 | 2007-05-10 |
| 1639381569 | Emeritus Corporation | Assisted Living Facility | 1372 Southwest 8th Avenue, Ontario, OR 97914 | 2007-05-04 |
| Find all providers in zip 97914 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477629 | Karen J Pompa | Peer Specialist | 2605 E Date Palm Paseo Apt 2194, Ontario, CA 91764-4670 | 2020-11-05 |
| 1003447442 | Noah Nguyen | Peer Specialist | 2940 Inland Empire Blvd, Ontario, CA 91764-4898 | 2020-02-03 |
| 1134764285 | Vivien Naomi Limon | Peer Specialist | 2940 Inland Empire Blvd, Ontario, CA 91764-4898 | 2019-11-13 |
| 1194360248 | Gerald Lee Wilson | Peer Specialist | 2940 Inland Empire Blvd, Ontario, CA 91764-4898 | 2019-11-13 |
| 1356982466 | Byron Mitchell Shock | Peer Specialist | 702 Sunset Dr, Ontario, OR 97914-3121 | 2019-10-01 |
| 1386930642 | Joni Ursula Kincer | Peer Specialist | 2940 Inland Empire Blvd, Ontario, CA 91764-4898 | 2011-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487255576 | Thomas Roy Hooks | Peer Specialist | 1221 Sw 11th Ave Apt 102, Portland, OR 97205-2143 | 2020-11-04 |
| 1578162145 | Kenneth Branson | Peer Specialist | 389 Sw Scalehouse Ct Ste 130, Bend, OR 97702-3241 | 2020-10-23 |
| 1962000554 | Dawn Marks | Peer Specialist | 21440 Se Stark St, Gresham, OR 97030-2024 | 2020-10-15 |
| 1679188080 | Michelle Marie Bunkers | Peer Specialist | 20517 Jacklight Ln, Bend, OR 97702-2971 | 2020-09-11 |
| 1538773155 | Mamie Nzigire Zagabe | Peer Specialist | 605 Se Cesar Estrada Chavez Blvd, Portland, OR 97214 | 2020-09-01 |
| 1528677820 | Charice Monette | Peer Specialist | 4151 Kacey Cir Ne, Salem, OR 97305-4504 | 2020-07-23 |
| 1841810322 | Ariana Lee May | Peer Specialist | 1601 Olive St Apt 1008, Eugene, OR 97401-3985 | 2020-04-24 |
| 1982237236 | Jessica M Montoya | Peer Specialist | 235 Se Knowledge St, Prineville, OR 97754-2362 | 2020-02-14 |
| 1134752579 | Lisa Kennedy | Peer Specialist | 132 Ne B St # 24, Grants Pass, OR 97526-2114 | 2020-02-13 |
| 1730711953 | Michael Anthony Duran | Peer Specialist | 1515 Hill St Se, Albany, OR 97322-6715 | 2020-02-05 |
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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.