AUSTIN C SULLIVAN (NPI# 1548882723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548882723 |
| Entity Type | Individual |
| Full Name | AUSTIN C SULLIVAN |
| Practice Address |
7405 Se 84th Ave Portland OR 97266-5840 |
| Mailing Address |
Po Box 8459 Portland OR 97207-8459 |
| Practice Telephone | 5037711645 |
| Mailing Telephone | 5032380769 |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2020-05-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 372600000X | Adult Companion | Nursing Service Related Providers |
| Street Address |
7405 SE 84TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97266-5840 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447654504 | Cascadia Behavioral Health Care | Community Based Residential Treatment Facility, Mental Illness | 7405 Se 84th Ave, Portland, OR 97266-5840 | 2014-10-20 |
| 1083212781 | Haili Michelle Jones | Technician | 7405 Se 84th Ave, Portland, OR 97266-5840 | 2020-10-14 |
| 1689299711 | Jessica Rose Elizabeth Jones | Technician | 7405 Se 84th Ave, Portland, OR 97266-5840 | 2020-06-15 |
| 1346871415 | Sarah Reilly | Adult Companion | 7405 Se 84th Ave, Portland, OR 97266-5840 | 2020-01-28 |
| 1326680828 | David Ong | Adult Companion | 7405 Se 84th Ave, Portland, OR 97266-5840 | 2019-10-16 |
| 1275193286 | Chloe Ella Fisher | Counselor | 7405 Se 84th Ave, Portland, OR 97266-5840 | 2019-06-20 |
| 1093111536 | Eugene Alven Nelson | Adult Companion | 7405 Se 84th Ave, Portland, OR 97266-5840 | 2014-11-11 |
| 1457757999 | Shane Austin Smith | Adult Companion | 7405 Se 84th Ave, Portland, OR 97266-5840 | 2014-11-11 |
| 1538565080 | Lee Bethany Bostwick | Adult Companion | 7405 Se 84th Ave, Portland, OR 97266-5840 | 2014-11-11 |
| 1265838718 | Roslina Gidbmaa X | Adult Companion | 7405 Se 84th Ave, Portland, OR 97266-5840 | 2014-11-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528545969 | Willamette Pharmacy | Pharmacy | 10209 Se Division Build B Ste 100, Portland, OR 97266 | 2018-07-27 |
| 1992204697 | Sober Living Oregon Treatment Center | Clinic/Center | 10209 Se Division, Portland, OR 97266 | 2018-02-08 |
| 1699204024 | Malori Christine Butler | Registered Nurse | 7335 Se 85th Ave., Portland, OR 97266 | 2017-06-08 |
| 1487028882 | Emil Kunkel | Naturopath | 6318 Se 87th Ave, Portland, OR 97266 | 2015-11-23 |
| 1194195313 | Cory Hall-martin | Counselor | 10011 Se Division St #305, Portland, OR 97266 | 2015-09-30 |
| 1336517721 | Krispin Mayfield | Counselor | 10011 Se Division St., Suite 203, Portland, OR 97266 | 2015-09-02 |
| 1407247927 | Syrena Nicholson | Community Health Worker | 7721 Se 92nd Avenue, Apt K, Portland, OR 97266 | 2015-02-06 |
| 1659777886 | Berhanu Aynalem Mekbib | Adult Companion | 9125 Sw 55th, El Dorado, Portland, OR 97266 | 2014-11-17 |
| 1871930685 | Felicitas Amelia Penaloza | Behavioral Analyst | 9911 Se Mt.scott Boulevard, Portland, OR 97266 | 2013-06-03 |
| 1710237326 | Janna Renee Higgins | Case Manager/Care Coordinator | 9911 Se Mt. Scott Boulevard, Portland, OR 97266 | 2012-09-12 |
| Find all providers in zip 97266 | ||||
| Taxonomy Code | 372600000X |
| Grouping | Nursing Service Related Providers |
| Classification | Adult Companion |
| An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184271462 | Taylor Salter | Adult Companion | 7018 N Armour St, Portland, OR 97203-6132 | 2019-08-21 |
| 1235785429 | Lonzall Tatum | Adult Companion | 1212 Sw Clay St Apt 409, Portland, OR 97201-7822 | 2019-08-13 |
| 1205303021 | Imani Anderson | Adult Companion | 434 Ne Roselawn St, Portland, OR 97211-3826 | 2018-10-30 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1104364900 | Rosanna Hunnicutt | Adult Companion | 2601 Se 160th Ave, Portland, OR 97236-2092 | 2017-02-01 |
| 1043755028 | Raolat Ajibade IIi | Adult Companion | 847 N.e 19thave, Portland, OR 97232 | 2016-12-29 |
| 1164972675 | Rachael Anderson | Adult Companion | 423 Ne 160th Ave #11, Portland, OR 97230 | 2016-10-07 |
| 1255789731 | Sherri Schroeder | Adult Companion | 847 Ne 19th Ave., Suite100, Portland, OR 97232 | 2016-05-25 |
| 1750740577 | Sheila Amoo | Adult Companion | 236 N Killingworth St. Apt.b104, Portland, OR 97217 | 2016-02-22 |
| 1609241371 | Denise Broom | Adult Companion | 25 Ne Stafford St, Portland, OR 97211-2241 | 2015-12-07 |
| 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.