COLUMBIACARE SERVICES (NPI# 1700273638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700273638 |
| Entity Type | Organization |
| Organization Name | COLUMBIACARE SERVICES |
| Practice Address |
17700 Ne Halsey St Portland OR 97230-6734 |
| Mailing Address |
3587 Heathrow Way Medford OR 97504 |
| Practice Telephone | 5418588170 |
| Practice Fax Number | 5418588167 |
| Mailing Telephone | 5418588170 |
| Mailing Fax Number | 5418588167 |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2015-04-17 |
| Authorized Official Name | MIKE DAVID SEWITSKY (FINANCE MANAGER) |
| Authorized Official Telephone | 5418588170 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427553692 | Columbiacare Services | Clinic/Center | 29415 Russell St, Gold Beach, OR 97444 | 2018-03-28 |
| 1255835104 | Columbiacare Services | Clinic/Center | 850 Swing Ln, Medford, OR 97501-1790 | 2018-03-23 |
| 1982140588 | Columbiacare Services | Clinic/Center | 17720 Ne Halsey St # 1, Portland, OR 97230-6734 | 2017-01-06 |
| 1831640192 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 8336 Highway 62, White City, OR 97530 | 2016-10-20 |
| 1871946640 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 29841 Hillcrest St, Gold Beach, OR 97444-8714 | 2016-07-18 |
| 1194173898 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 410 Maple St, Brookings, OR 97415 | 2016-06-03 |
| 1679941785 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 130 Se 119th Ave, Portland, OR 97216-3704 | 2015-09-04 |
| 1346637816 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 17710 Halsey Crc, Portland, OR 97230 | 2015-04-22 |
| 1740679182 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 11380 Se Greenburg Rd #9, Tigard, OR 97223 | 2015-01-22 |
| 1255720645 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 11380 Se Greenburg Rd # 10, Tigard, OR 97223 | 2015-01-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | COLUMBIACARE SERVICES, INC | 3587 Heathrow Way, Medford, OR 97504 |
| Oregon Corporations, Companies and Business Names | COLUMBIACARE SERVICES, INC. | 3587 Heathrow Way, Medford, OR 97504 |
| Street Address |
17700 NE HALSEY ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97230-6734 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932687233 | Timisha K Wilson | Social Worker | 12505 Ne Halsey St, Portland, OR 97230 | 2018-07-30 |
| 1356828768 | Sally Gail Logan | Pharmacist | 5725 Ne 138th Avenue, Portland, OR 97230 | 2018-07-27 |
| 1063937951 | Marley Elizabeth Small | Counselor | 1507 Ne 122nd Ave., Portland, OR 97230 | 2017-08-11 |
| 1447771316 | Shadab Nasreen Aijazi | Pathology | 5220 Ne 122nd Avenue, Portland, OR 97230 | 2017-06-30 |
| 1104378199 | Derek Andrus | Pharmacist | 5717 Nw 138th, Portland, OR 97230 | 2016-10-26 |
| 1164972675 | Rachael Anderson | Adult Companion | 423 Ne 160th Ave #11, Portland, OR 97230 | 2016-10-07 |
| 1750837597 | Providence Elderplace | Assisted Living Facility | 16430 Ne Hoyt St, Portland, OR 97230 | 2016-08-31 |
| 1649622473 | Sara Mcgroarty | Counselor | 17710 Ne Halsey Street, Portland, OR 97230 | 2016-07-05 |
| 1346699949 | Steven D Stanton | Counselor | 1022 Ne 181st Ave, C1, Portland, OR 97230 | 2016-06-06 |
| 1215390091 | The Wallace Medical Concern | Clinic/Center | 18139 Ne Couch Street, Portland, OR 97230 | 2016-03-30 |
| Find all providers in zip 97230 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558732966 | John William Thompson | Community Based Residential Treatment Facility, Mental Illness | 5538 Ne 24th Ave, Portland, OR 97211-6206 | 2015-10-12 |
| 1679941785 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 130 Se 119th Ave, Portland, OR 97216-3704 | 2015-09-04 |
| 1346637816 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 17710 Halsey Crc, Portland, OR 97230 | 2015-04-22 |
| 1447654504 | Cascadia Behavioral Health Care | Community Based Residential Treatment Facility, Mental Illness | 7405 Se 84th Ave, Portland, OR 97266-5840 | 2014-10-20 |
| 1386047132 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 3530 Se 136th Ave. #5, Portland, OR 97236 | 2014-10-07 |
| 1821491853 | Florence Mutie | Community Based Residential Treatment Facility, Mental Illness | 5123 Sw 62nd Ave, Portland, OR 97221-1170 | 2014-10-05 |
| 1679983381 | Janus Youth Program | Community Based Residential Treatment Facility, Mental Illness | 142 Se 160th Ave Apt 24, Portland, OR 97233-3558 | 2014-05-02 |
| 1558606384 | Renew Consulting, Inc. | Community Based Residential Treatment Facility, Mental Illness | 12810 Sw 62nd Ave, Portland, OR 97219-8034 | 2012-12-05 |
| 1558686576 | Mentor Abi | Community Based Residential Treatment Facility, Mental Illness | 9125 Sw 55th Ave, Portland, OR 97219-5018 | 2010-04-01 |
| 1841435518 | Cameron Care Powell | Community Based Residential Treatment Facility, Mental Illness | 14309 Se Powell Blvd, Portland, OR 97236 | 2008-12-10 |
| 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.