COFFEE CREEK CORRECTION FACILITY (NPI# 1619397767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619397767 |
| Entity Type | Organization |
| Organization Name | COFFEE CREEK CORRECTION FACILITY |
| Other Organization Name | TURNING POINT PROGRAM |
| Practice Address |
847 Ne 19th Ave Suite 100 Portland OR 97232-2684 |
| Practice Telephone | 5032380769 |
| Practice Fax Number | 5039637711 |
| Mailing Telephone | 5032380769 |
| Mailing Fax Number | 5039637711 |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2014-04-16 |
| Authorized Official Name | DR. DERALD WALKER (PRESIDENT / CEO) |
| Authorized Official Telephone | 5032380769 |
| Authorized Official Credential | PHD |
| 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 |
| Other Name | Type Code |
|---|---|
| Turning Point Program | Other Name - Individual/Organization |
| Street Address |
847 NE 19TH AVE SUITE 100 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97232-2684 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265417174 | Oregon Clinic PC | Obstetrics & Gynecology | 847 Ne 19th Ave, Suite 300, Portland, OR 97232-2684 | 2005-12-13 |
| 1366073504 | Angela R Osipovich | Adult Companion | 847 Ne 19th Ave, Portland, OR 97232-2684 | 2020-01-27 |
| 1649829714 | Shane Dalton Wight | Adult Companion | 847 Ne 19th Ave, Portland, OR 97232-2684 | 2019-09-10 |
| 1922650043 | Sean Smith | Registered Nurse | 847 Ne 19th Ave, Portland, OR 97232-2684 | 2019-07-09 |
| 1518528942 | Lori Horton | Registered Nurse | 847 Ne 19th Ave, Portland, OR 97232-2684 | 2019-06-26 |
| 1629636014 | Emma Lee Patton | Counselor | 847 Ne 19th Ave, Portland, OR 97232-2684 | 2019-05-31 |
| 1285299024 | James Richard Broker | Counselor | 847 Ne 19th Ave, Portland, OR 97232-2684 | 2019-05-07 |
| 1912460783 | Jessica Kay Long | Adult Companion | 847 Ne 19th Ave, Portland, OR 97232-2684 | 2019-04-09 |
| 1538622311 | Kendall Frances Burns | Community Health Worker | 847 Ne 19th Ave, Portland, OR 97232-2684 | 2019-04-09 |
| 1396203014 | Shala Muldrew | Adult Companion | 847 Ne 19th Ave, Portland, OR 97232-2684 | 2019-03-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 | 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.