CASCADIA BEHAVIORAL HEALTHCARE INC (NPI# 1528145794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1528145794 |
Entity Type | Organization |
Organization Name | CASCADIA BEHAVIORAL HEALTHCARE INC |
Other Organization Name | 75TH AVE HOUSE |
Practice Address |
4729 Se 75th Ave Portland OR 97206 |
Mailing Address |
Po Box 8459 Portland OR 97207-8459 |
Practice Telephone | 5037881680 |
Practice Fax Number | 5037881686 |
Mailing Telephone | 5032380769 |
Mailing Fax Number | 5035526208 |
Enumeration Date | 2006-11-01 |
Last Update Date | 2008-06-18 |
NPI Deactivation Date | 06/05/2008 |
NPI Reactivation Date | 2008-06-17 |
Authorized Official Name | ENRIQUE SAMA (VP, HUMAN RESOURCES) |
Authorized Official Telephone | 5039637791 |
Is Organization Subpart | Y |
Parent Organization Name | CASCADIA BEHAVIORAL HEALTHCARE INC |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | 223347 | 05 | |
OR | 226398 | 05 |
Other Name | Type Code |
---|---|
75th Ave House | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871632000 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 1137 25th St Ne, Salem, OR 97301-1604 | 2007-02-05 |
1548309776 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 1023 Ne Emerson St, Portland, OR 97211-4336 | 2007-02-05 |
1144369356 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 3909 Se 70th Avenue, Portland, OR 97206-2525 | 2007-02-05 |
1841360161 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 5023 Ne Killingsworth St, Portland, OR 97218-1915 | 2006-11-08 |
1538238928 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 1095 25th St Se, Salem, OR 97301-5049 | 2006-11-07 |
1669541058 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 326 Se 76th Ave, Portland, OR 97215-1468 | 2006-11-07 |
1215006606 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 959 Ne 165th Ave, Portland, OR 97230-6148 | 2006-11-07 |
1982783965 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 7003 Se Woodstock Blvd, Portland, OR 97206-5940 | 2006-11-02 |
1396822763 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 399 Young St, Woodburn, OR 97071-4817 | 2006-11-01 |
1225115595 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 1232 Nw 23rd Ave, Portland, OR 97210-2906 | 2006-11-01 |
Street Address |
4729 SE 75TH AVE |
City | PORTLAND |
State | OR |
Zip Code | 97206 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861800377 | Brittany Mckenna | Adult Companion | 4729 Se 75th Ave, Portland, OR 97206-4351 | 2014-07-28 |
1730433202 | Maurice Stephens | Adult Companion | 4729 Se 75th Ave, Portland, OR 97206-4351 | 2012-11-05 |
1710254263 | Brittney Marie Anderson | Adult Companion | 4729 Se 75th Ave, Portland, OR 97206-4351 | 2011-11-29 |
1881999332 | Zoralya Alexandra Elisa | Adult Companion | 4729 Se 75th Ave, Portland, OR 97206-4351 | 2011-01-13 |
1023246055 | Sara Kiely | Adult Companion | 4729 Se 75th Ave, Portland, OR 97206-4351 | 2009-06-29 |
1821135344 | Sara Ann Kocher | Adult Companion | 4729 Se 75th Ave, Portland, OR 97206-4351 | 2007-02-01 |
1487790796 | Daniel William Conrad Schermele | Adult Companion | 4729 Se 75th Ave, Portland, OR 97206-4351 | 2007-01-30 |
1508912882 | Robert Barry Bernstein | Case Manager/Care Coordinator | 4729 Se 75th Ave, Portland, OR 97206-4351 | 2007-01-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346852365 | Amanda Kristine Fredrickson | Dietitian, Registered | 3611 Se 64th Ave., Portland, OR 97206 | 2020-08-20 |
1578108940 | Amy Groulx | Technician | 5506 Se Mitchell St, Portland, OR 97206 | 2019-11-08 |
1477061265 | Lisa Marie Matejka | Naturopath | 5235 Se Lambert St, Apt. #b6, Portland, OR 97206 | 2018-01-16 |
1639625205 | Mollie Kathleen Pence | Registered Nurse | 2415 43rd Ave, Suite 100, Cascadia Behavioral Healthcare Urgent Walkin Clinic, Portland, OR 97206 | 2016-09-01 |
1457709164 | Lauren Murdoch | Massage Therapist | 4629 Southeast Woodstock Boulevard, Portland, OR 97206 | 2016-06-03 |
1962897785 | Meigra Simon LLC | Mechanotherapist | 6842 Se Henry St, Portland, OR 97206 | 2015-03-30 |
1891186508 | Teresa Leckron-myers | Case Manager/Care Coordinator | 7916 Se Foster Rd, Portland, OR 97206 | 2015-02-17 |
1831597590 | Boey Yean Lim | Acupuncturist | 4629 Se Woodstock Blvd, Portland, OR 97206 | 2014-12-12 |
1295082329 | Chase Heywood Price | Acupuncturist | 5425 Se Raymond Street, Portland, OR 97206 | 2012-08-08 |
1154678423 | Annelise Sevastiana Schnase | Counselor | 4311 Se Woodstock Blvd, Portland, OR 97206 | 2012-08-06 |
Find all providers in zip 97206 |
Taxonomy Code | 261QM1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Multi-Specialty |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588153076 | Kaiser Foundation Health Plan of The Northwest | Clinic/Center | 3060 Se Hawthorne Blvd, Portland, OR 97214-4121 | 2018-05-09 |
1255844908 | Affordable Health Care & Chiropractic Inc | Clinic/Center | 2130 Se 96th Ave, Portland, OR 97216-2603 | 2017-11-15 |
1548309776 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 1023 Ne Emerson St, Portland, OR 97211-4336 | 2007-02-05 |
1144369356 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 3909 Se 70th Avenue, Portland, OR 97206-2525 | 2007-02-05 |
1841360161 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 5023 Ne Killingsworth St, Portland, OR 97218-1915 | 2006-11-08 |
1669541058 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 326 Se 76th Ave, Portland, OR 97215-1468 | 2006-11-07 |
1215006606 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 959 Ne 165th Ave, Portland, OR 97230-6148 | 2006-11-07 |
1982783965 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 7003 Se Woodstock Blvd, Portland, OR 97206-5940 | 2006-11-02 |
1225115595 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 1232 Nw 23rd Ave, Portland, OR 97210-2906 | 2006-11-01 |
1710064035 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 2270 Se 39th Ave, Portland, OR 97214-5916 | 2006-11-01 |
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.