ANN ELIZABETH SRODULSKI (NPI# 1538449673) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538449673 |
| Entity Type | Individual |
| Full Name | ANN ELIZABETH SRODULSKI |
| Credential | MA |
| Practice Address |
1500 Ne Irving St Suite 250 Portland OR 97232-2243 |
| Mailing Address |
9479 Sw Maplewood Dr B14 Tigard OR 97223-4966 |
| Practice Telephone | 5032584200 |
| Mailing Telephone | 8475027607 |
| Enumeration Date | 2011-08-21 |
| Last Update Date | 2011-08-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers |
| Street Address |
1500 NE IRVING ST SUITE 250 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97232-2243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952451841 | Andrew Todd Mcwilliams | Counselor | 1500 Ne Irving St, 250, Portland, OR 97232-2243 | 2007-01-11 |
| 1609230168 | Anita Loving | Peer Specialist | 1500 Ne Irving St, 250, Portland, OR 97232-2243 | 2016-04-11 |
| 1518207661 | Robert Christopher Goble | Social Worker | 1500 Ne Irving St, Suite 200, Portland, OR 97232-2243 | 2013-02-27 |
| 1083954218 | Martha M Robers | Social Worker | 1500 Ne Irving St, Suite 200, Portland, OR 97232-2243 | 2013-02-25 |
| 1902155583 | Keysha Rae Kendall | Student in an Organized Health Care Education/Training Program | 1500 Ne Irving St, Suite 250, Portland, OR 97232 | 2012-08-29 |
| 1346527694 | Kristin Warden Doherty | Social Worker | 1500 Ne Irving St, Suite 250, Portland, OR 97232-2243 | 2011-11-14 |
| 1922385095 | Laura C Berger | Social Worker | 1500 Ne Irving St, Suite 250, Portland, OR 97232-2243 | 2011-11-03 |
| 1164705257 | Kelsey Stone | Case Manager/Care Coordinator | 1500 Ne Irving St, Suite 250, Portland, OR 97232-2243 | 2011-09-24 |
| 1316220916 | Grace Huang | Counselor | 1500 Ne Irving St, Suite 250, Portland, OR 97232-2243 | 2011-09-21 |
| 1285916270 | Elizabeth Brown | Student in an Organized Health Care Education/Training Program | 1500 Ne Irving St, Suite 250, Portland, OR 97232-2243 | 2011-09-15 |
| Find all providers in the same location | ||||
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|---|---|---|---|---|
| 1881293215 | Oregon Change Clinic | Clinic/Center | 650 Ne Holladay Street, Suite 1600, Portland, OR 97232 | 2020-10-17 |
| 1154969947 | Lori Kristen Miracle | Acupuncturist | Kwan Yin Healing Arts Center East Inc, 3115 Ne Sandy Blvd. Suite 231, Portland, OR 97232 | 2019-12-12 |
| 1194285411 | Onampai Modina Soondarotok | Student in an Organized Health Care Education/Training Program | Ipp, Oregon Health & Science University, 2214 Lloyd Center, Portland, OR 97232 | 2019-03-22 |
| 1003399635 | Cathleen Nicole Wenberg | Social Worker | 1839 Ne Couch St, Portland, OR 97232 | 2018-09-10 |
| 1508350760 | Float North | Acupuncturist | 1617 Ne 17th Ave., Portland, OR 97232 | 2018-06-20 |
| 1629560719 | Rachael Lee Walters | Doula | 3005 Ne Hoyt St, Portland, OR 97232 | 2018-06-04 |
| 1225529431 | Jason Sutherland | Social Worker | 707 Ne Couch, Portland, OR 97232 | 2018-05-23 |
| 1770089245 | Richard Farwell Leman | Family Medicine | 800 Ne Oregon St., Suite 772, Portland, OR 97232 | 2018-04-03 |
| 1952803413 | Aleksandra Giedowyn Md PC | Family Medicine | 1923 Ne Broadway Street Suite 2, Portland, OR 97232 | 2018-03-01 |
| 1639680374 | Amanda Matteo | Counselor | 20 Ne 10th Ave, Portland, OR 97232 | 2017-10-20 |
| Find all providers in zip 97232 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912530643 | Positive Development for Youth and Families, Inc. | Psychologist | 4531 Se Belmont St Ste 110, Portland, OR 97215-1675 | 2020-02-21 |
| 1902440704 | Alicia Hoffman | Psychologist | 1577 Congress St Ste 2, Portland, ME 04102-2169 | 2019-11-05 |
| 1467819631 | Megan Nichols | Psychologist | 2734 Se 29th Ave, Apt B, Portland, OR 97202-1381 | 2016-01-19 |
| 1891043360 | Margaret Arnold Stoeckel | Psychologist | 5041 Se Taylor St, Portland, OR 97215-2624 | 2012-08-15 |
| 1851532139 | Charlene Eickholt | Psychologist | 1405 Ne Broadway, Suite # 200, Portland, OR 97232-1497 | 2009-03-16 |
| 1215081716 | Holly Linn Crossen | Psychologist | 1130 Sw Morrison St Ste 618, Portland, OR 97205-2217 | 2007-01-22 |
| 1972654697 | Nicholas John Ure | Psychologist | 101 Se 12th Ave, Portland, OR 97214-1319 | 2007-01-16 |
| 1528134772 | Marianne Michelle Kabour | Psychologist | 2801 N Gantenbein Ave Fl 3, Portland, OR 97227-1623 | 2006-11-28 |
| 1578588539 | Shirley May Hanson | Psychologist | 7912 Sw 35th Ave, Suite 6, Portland, OR 97219-2427 | 2006-07-12 |
| 1518904457 | Redmond Andrew Reams | Psychologist | 2106 Ne 40th Ave, Portland, OR 97212-5405 | 2006-05-31 |
| 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.