DAVID PUNGERCAR (NPI# 1700265147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700265147 |
| Entity Type | Individual |
| Full Name | DAVID PUNGERCAR |
| Practice Address |
4347 Sunnyview Rd. Ne Salem OR 97305 |
| Mailing Address |
715 Sw Ramsey Ave Grants Pass OR 97527-5500 |
| Practice Telephone | 5419564943 |
| Mailing Telephone | 5419564943 |
| Mailing Fax Number | 5419565463 |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2015-05-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Street Address |
4347 SUNNYVIEW RD. NE |
| City | SALEM |
| State | OR |
| Zip Code | 97305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588057004 | Carmen Heidecke | Counselor | 4347 Sunnyview Rd. Ne, Salem, OR 97305 | 2015-03-08 |
| 1770963472 | Andrea Mcmillan | Counselor | 4347 Sunnyview Rd. Ne, Salem, OR 97305-3547 | 2015-06-08 |
| 1215315700 | Sheena Kearney | Counselor | 4347 Sunnyview Rd. Ne, Salem, OR 97305 | 2015-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821639147 | Christine Ann Featherstone | Social Worker | Chemawa Indian Health Center, 3750 Chemawa Road, Salem, OR 97305 | 2019-10-08 |
| 1962996553 | Erin Ann Wakefield | Non-emergency Medical Transport (VAN) | 2425 Fisher Rd Ne, Salem, OR 97305 | 2018-06-18 |
| 1770002271 | Traci L Lee | Case Manager/Care Coordinator | 3876 Beverly Ave Bldg G, Salem, OR 97305 | 2017-09-15 |
| 1952825762 | Matthew Paul Martin | Dentist | 2737 Lancaster Dr Ne Ste 150, Salem, OR 97305 | 2017-08-02 |
| 1043750367 | Sherri King | Physical Therapy Assistant | 4696 Reimann St Ne, Salem, OR 97305 | 2017-03-06 |
| 1760861314 | Amara Lenore Peterson | Counselor | 4347 Sunnyview Rd Ne, Salem, OR 97305 | 2015-05-28 |
| 1720467954 | Heather Rose | Community Health Worker | 4347 Sunnyview Road Ne, Salem, OR 97305 | 2015-05-20 |
| 1629476825 | Bryan James Greenaway | Audiologist | 3857 Wolverine St Ne Ste C-16, Salem, OR 97305 | 2014-12-21 |
| 1710300322 | Christopher Ryan | Counselor | 4385 Sunnyview Road Ne, Salem, OR 97305 | 2014-02-03 |
| 1841538154 | Holly Loescher | Hearing Instrument Specialist | 3066 Lancaster Drive Ne, Salem, OR 97305 | 2013-01-21 |
| Find all providers in zip 97305 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619097052 | Redemption, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 11780 Western Reserve Rd, Salem, OH 44460-7619 | 2007-03-30 |
| 1497205686 | Beacon Youth & Prevention Services | Residential Treatment Facility, Emotionally Disturbed Children | 3000 Market St Ne, Suite 528, Salem, OR 97301-1882 | 2016-10-11 |
| 1548636079 | Professional Therapuetic Community Network | Residential Treatment Facility, Emotionally Disturbed Children | 2905 River Rd S, Salem, OR 97302-9754 | 2015-08-19 |
| 1245487834 | Virginia Baptist Childrens Home and Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 860 Mount Vernon Ln, Salem, VA 24153-2700 | 2008-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811541568 | Dragonfly Programs, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 505 N 9th St, Klamath Falls, OR 97601-2876 | 2019-07-31 |
| 1740844984 | Brigacare, Incorporated | Residential Treatment Facility, Emotionally Disturbed Children | 15703 Sw Whetstone Way, Sherwood, OR 97140-8895 | 2019-04-23 |
| 1275085128 | Northwest Youth Discovery | Residential Treatment Facility, Emotionally Disturbed Children | 61850 Dobbin Rd, Bend, OR 97702-9536 | 2016-10-26 |
| 1427414895 | Polk Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 175 Ne Kings Valley Hwy Ste A, Dallas, OR 97338-1787 | 2016-01-14 |
| 1083070361 | Oregon 180 | Residential Treatment Facility, Emotionally Disturbed Children | 725 W 14th St, Medford, OR 97501-3429 | 2016-01-03 |
| 1013395953 | Bridges Academy Corp | Residential Treatment Facility, Emotionally Disturbed Children | 67030 Gist Rd, Bend, OR 97701-9209 | 2015-05-12 |
| 1336565993 | Northwest Youth Discovery | Residential Treatment Facility, Emotionally Disturbed Children | 9 Nw 15th St, Bend, OR 97701-3102 | 2014-03-06 |
| 1528499696 | Klamath Lake County Youth Ranch | Residential Treatment Facility, Emotionally Disturbed Children | 5800 Happy Hollow Ln, Bonanza, OR 97623-7714 | 2013-11-27 |
| 1487082681 | Yamhill County Juvenile Department | Residential Treatment Facility, Emotionally Disturbed Children | 535 E 5th St, Mcminnville, OR 97128-4504 | 2013-10-24 |
| 1154758266 | Youth Guidance Association | Residential Treatment Facility, Emotionally Disturbed Children | 2730 Ne Flanders St, Portland, OR 97232-3160 | 2013-10-03 |
| Find all providers with the same taxonomy | ||||
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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.