TYLER JAMES BOULANGER (NPI# 1700486586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700486586 |
| Entity Type | Individual |
| Full Name | TYLER JAMES BOULANGER |
| Practice Address |
2415 Se 43rd Ave Portland OR 97206-1600 |
| Mailing Address |
327 Nw Gina Way Apt 229 Hillsboro OR 97006-4494 |
| Practice Telephone | 5032380705 |
| Practice Fax Number | 5032367166 |
| Mailing Telephone | 5039270389 |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2020-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers |
| Street Address |
2415 SE 43RD AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97206-1600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164404836 | David John Kohler | Counselor | 2415 Se 43rd Ave, Suite 100, Portland, OR 97206-1600 | 2005-11-17 |
| 1598385379 | Kathy J Kelly | Registered Nurse | 2415 Se 43rd Ave, Portland, OR 97206-1600 | 2020-04-21 |
| 1689214967 | Emily Hays | Case Manager/Care Coordinator | 2415 Se 43rd Ave, Portland, OR 97206-1600 | 2020-01-14 |
| 1083258750 | Emily Wilder | Counselor | 2415 Se 43rd Ave, Portland, OR 97206-1600 | 2019-11-05 |
| 1639580012 | Richard Gear | Counselor | 2415 Se 43rd Ave, Suite 200, Portland, OR 97206-1600 | 2014-05-19 |
| 1427468982 | Kristina Hankamp | Adult Companion | 2415 Se 43rd Ave, Suite 200, Portland, OR 97206-1600 | 2014-05-05 |
| 1427477405 | Kayla Cronenbold | Counselor | 2415 Se 43rd Ave, Portland, OR 97206-1600 | 2014-04-07 |
| 1770900136 | Pavlina Rodriguez | Counselor | 2415 Se 43rd Ave, Portland, OR 97206-1600 | 2014-03-24 |
| 1508282989 | M Selena Bellas | Counselor | 2415 Se 43rd Ave, Portland, OR 97206-1600 | 2014-03-10 |
| 1578986592 | Mary Bryant | Community Health Worker | 2415 Se 43rd Ave, Portland, OR 97206-1600 | 2014-01-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346852365 | Amanda Kristine Fredrickson | Dietitian, Registered | 3611 Se 64th Ave., Portland, OR 97206 | 2020-08-20 |
| 1578108940 | Amy Groulx | Technician | 5506 Se Mitchell St, Portland, OR 97206 | 2019-11-08 |
| 1477061265 | Lisa Marie Matejka | Naturopath | 5235 Se Lambert St, Apt. #b6, Portland, OR 97206 | 2018-01-16 |
| 1639625205 | Mollie Kathleen Pence | Registered Nurse | 2415 43rd Ave, Suite 100, Cascadia Behavioral Healthcare Urgent Walkin Clinic, Portland, OR 97206 | 2016-09-01 |
| 1457709164 | Lauren Murdoch | Massage Therapist | 4629 Southeast Woodstock Boulevard, Portland, OR 97206 | 2016-06-03 |
| 1962897785 | Meigra Simon LLC | Mechanotherapist | 6842 Se Henry St, Portland, OR 97206 | 2015-03-30 |
| 1891186508 | Teresa Leckron-myers | Case Manager/Care Coordinator | 7916 Se Foster Rd, Portland, OR 97206 | 2015-02-17 |
| 1831597590 | Boey Yean Lim | Acupuncturist | 4629 Se Woodstock Blvd, Portland, OR 97206 | 2014-12-12 |
| 1295082329 | Chase Heywood Price | Acupuncturist | 5425 Se Raymond Street, Portland, OR 97206 | 2012-08-08 |
| 1154678423 | Annelise Sevastiana Schnase | Counselor | 4311 Se Woodstock Blvd, Portland, OR 97206 | 2012-08-06 |
| Find all providers in zip 97206 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932722345 | Izmirian Counseling, PC | Psychologist | 1450 Se Holgate Blvd, Portland, OR 97202-4717 | 2020-05-19 |
| 1669959078 | Pamela Michelle Taite | Psychologist | 1785 Ne Sandy Blvd Ste 270, Portland, OR 97232-2791 | 2018-07-27 |
| 1861850737 | Traci Rieckmann | Psychologist | 2925 Ne 53rd Ave, Portland, OR 97213-2437 | 2016-02-05 |
| 1417196999 | Elizabeth Rachael Starkweather | Psychologist | 212 Kent St Ste 4b, Portland, MI 48875-1448 | 2009-02-06 |
| 1477737294 | Bret Eugene Fuller | Psychologist | 037 Sw Hamilton St, Ste 3, Portland, OR 97239-4096 | 2007-12-28 |
| 1942414222 | Kathy Karpeles | Psychologist | 651 Forest Ave, Portland, ME 04101-1525 | 2007-05-09 |
| 1174736573 | Frances I. Page | Psychologist | 2726 Sw Ridge Drive, Portland, OR 97219-6204 | 2007-05-08 |
| 1386867562 | Nancy Kao Rhiannon | Psychologist | 2250 Nw Flanders St Ste 103, Portland, OR 97210-5409 | 2007-04-10 |
| 1477688000 | Britta Dinsmore | Psychologist | 7929 Sw 37th Ave, Suite D, Portland, OR 97219-3663 | 2007-02-23 |
| 1528111804 | Donald Dale Cohen | Psychologist | 511 Sw 10th Ave Ste 604, Portland, OR 97205-2707 | 2007-01-19 |
| 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.