ETHAN J NEWCOMB


Address: 1438 Se Division St, Portland, OR 97202-1140
Phone: 5035480346

ETHAN J NEWCOMB (NPI# 1699373324) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1699373324
Entity Type Individual
Full Name ETHAN J NEWCOMB
Credential PSS
Practice Address 1438 Se Division St
Portland
OR 97202-1140
Mailing Address 1776 Sw Madison St
Portland
OR 97205-1715
Practice Telephone 5035480346
Practice Fax Number 5032325959
Mailing Telephone 5032241044
Mailing Fax Number 5036212235
Enumeration Date 2020-10-14
Last Update Date 2020-10-14
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 175T00000X Peer Specialist OR Other Service Providers

Office Location

Street Address 1438 SE DIVISION ST
City PORTLAND
State OR
Zip Code 97202-1140

Providers in the same location

NPI Name Taxonomy Address Enumeration
1750370680 Marcela J Vinocur Psychiatry & Neurology 1438 Se Division St, Portland, OR 97202-1140 2005-10-13
1568079929 Richard J Breunissen Counselor 1438 Se Division St, Portland, OR 97202-1140 2020-09-29
1881202067 Shannon L Redmond Counselor 1438 Se Division St, Portland, OR 97202-1140 2020-07-14
1093338485 Lindy D Resner Counselor 1438 Se Division St, Portland, OR 97202-1140 2020-05-20
1326678871 Chandra K Wilson Counselor 1438 Se Division St, Portland, OR 97202-1140 2020-01-23
1235789314 Kirsten R Farmer Counselor 1438 Se Division St, Portland, OR 97202-1140 2019-09-19
1992366652 Viola Kaye Rogers Counselor 1438 Se Division St, Portland, OR 97202-1140 2019-06-24
1194289520 Jackson D Gambee Counselor 1438 Se Division St, Portland, OR 97202-1140 2019-01-30
1063983435 Natalie J Thomas Counselor 1438 Se Division St, Portland, OR 97202-1140 2018-12-11
1922591387 Rene J Rice Counselor 1438 Se Division St, Portland, OR 97202 2018-06-11
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1073143442 Carewell LLC Counselor Portland River Park Center, 205 Se Spokane St Suite 358, Portland, OR 97202 2020-01-24
1588226765 Melissa Lynn Hartley Counselor 1235 Se Division St. Suite 103, Portland, OR 97202 2019-07-08
1275192999 Kimberly Rae Kilgore Counselor 5509 Se 22nd St #3a, Portland, OR 97202 2019-06-06
1639736069 Kyra Steinhauer Social Worker 3145 Se Powell Blvd, Portland, OR 97202 2019-05-21
1134644321 Bridgette Hennigsen Social Worker 3810 Se 11th Ave, Portland, OR 97202 2017-08-08
1558895789 Lenore Cangeloso Acupuncturist 1235 Se Division Street, Suie 117, Portland, OR 97202 2017-04-14
1376099093 Anna Christine Leclerc Contractor 2024 Se Clinton Street, Zenana Spa and Wellness Center, Portland, OR 97202 2016-09-01
1144684663 Catholic Charities Case Management 2740 Se Powell Blvd., Portland, OR 97202 2016-04-11
1881082097 Zoomcare Dental, P.C. Dentist 3130 Se Division Street, Building 2, Portland, OR 97202 2014-12-23
1124424700 Jessica Nash Counselor 6411 Se 17th Ave, Portland, OR 97202 2014-11-10
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Taxonomy Information

Taxonomy Code 175T00000X
Grouping Other Service Providers
Classification Peer Specialist

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1487255576 Thomas Roy Hooks Peer Specialist 1221 Sw 11th Ave Apt 102, Portland, OR 97205-2143 2020-11-04
1538773155 Mamie Nzigire Zagabe Peer Specialist 605 Se Cesar Estrada Chavez Blvd, Portland, OR 97214 2020-09-01
1245896307 Anthony James Hardy Peer Specialist 10336 Ne Wygant St, Portland, OR 97220-3368 2019-05-14
1881155596 Laray Jermaine Thomas Peer Specialist 11509 Se Stephens St, Portland, OR 97216-3660 2019-03-26
1932684248 Dorothy Joanna Burton Peer Specialist 3716 Ne Martin Luther King Blvd, Portland, OR 97212-1111 2018-10-02
1750886255 Steven Wade Peer Specialist 4512 Ne Portland Hwy, Portland, OR 97218-1363 2018-03-27
1669991212 Kimberly Jaye Randall Peer Specialist 17214 Se Division St Ste 2, Portland, OR 97236-1282 2017-09-14
1689103897 Walter Bulter Peer Specialist 5257 Ne Martin Luther King Jr Blvd Ste 202, Portland, OR 97211-3283 2017-06-09
1306373543 Brenda Kay Mitchell Peer Specialist 10373 Ne Hancock St Ste 132, Portland, OR 97220-3873 2017-05-18
1760914493 Changing Perceptions Peer Specialist 1720 Nw Lovejoy St # 329, Portland, OR 97209-2346 2017-03-31
Find all providers in PORTLAND

Competitor

Search similar providers

City PORTLAND
Zip Code 97202

Improve Information

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Dataset Information

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.

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