PAUL REVIS (NPI# 1770980906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770980906 |
| Entity Type | Individual |
| Full Name | PAUL REVIS |
| Practice Address |
2525 Portland St Apt 19 Eugene OR 97405-3107 |
| Practice Telephone | 5412328513 |
| Mailing Telephone | 5412328513 |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2014-12-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518984293 | Paul Revis | Dermatology | 1055 Featherstone Rd, Rockford, IL 61107-5904 | 2006-07-17 |
| Street Address |
2525 PORTLAND ST APT 19 |
| City | EUGENE |
| State | OR |
| Zip Code | 97405-3107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356985337 | Elizabeth Reed | Doula | 28192 Briggs Hill Rd, ., Eugene, OR 97405 | 2019-11-01 |
| 1235625450 | Kim Lynette Lesh | Counselor | 2434 Jacobs Lane, Eugene, OR 97405 | 2018-07-11 |
| 1841711884 | Mary Fiedler | Massage Therapist | 1924 Jackson Street, Eugene, OR 97405 | 2017-06-29 |
| 1235672478 | Icco LLC | Clinic/Center | 2710 Willamette Street, Eugene, OR 97405 | 2016-11-21 |
| 1033566633 | Andrea Armstrong | Counselor | 3575 Donald St Ste 130, Eugene, OR 97405 | 2016-05-24 |
| 1801265061 | Alani Stuart | Counselor | 3411-a Willamette Street, Eugene, OR 97405 | 2015-09-17 |
| 1992174155 | Lorena Cortes Cervantes | Counselor | 3411-a Willamette Street, Eugene, OR 97405 | 2015-09-17 |
| 1346626926 | Susan White | Speech-Language Pathologist | 3500 Hilyard St., Eugene, OR 97405 | 2015-08-05 |
| 1366826042 | Sherion Fulton | Counselor | 2852 Willamette #278, Eugene, OR 97405 | 2015-07-13 |
| 1336532860 | Heather Brooks Morse | Psychologist | 2228 West 25th Place, Eugene, OR 97405 | 2015-03-09 |
| Find all providers in zip 97405 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841810322 | Ariana Lee May | Peer Specialist | 1601 Olive St Apt 1008, Eugene, OR 97401-3985 | 2020-04-24 |
| 1053879361 | Carol Jeanne Hansen | Peer Specialist | 72a Centennial Loop Ste 150, Eugene, OR 97401-2447 | 2019-03-05 |
| 1558844324 | Roman Bezvikonnyi | Peer Specialist | 3086 Memory Ln, Eugene, OR 97404-1838 | 2018-09-07 |
| 1902305956 | Christine Noel Gray | Peer Specialist | 499 W. 4th Ave, Eugene, OR 97401 | 2018-02-06 |
| 1497296222 | Maria Regina Sison-valenti | Peer Specialist | 72a Centennial Loop, Suite 150, Eugene, OR 97401-2444 | 2017-03-13 |
| 1700335858 | Christina Gail Kazlas | Peer Specialist | 111 N Garfield St, Eugene, OR 97402-2619 | 2016-09-30 |
| 1316396187 | Matthew Allen Harlan | Peer Specialist | 4300 Goodpasture Loop, Apt.# 11, Eugene, OR 97401-1458 | 2016-06-12 |
| 1265888127 | Chenoa Bostick | Peer Specialist | 2525 Portland St, Eugene, OR 97405-3153 | 2016-05-10 |
| 1568607935 | Randy Jay Gudeika | Peer Specialist | 2145 Centennial Plaza, Laurel Hill Center, Eugene, OR 97401-2421 | 2008-12-12 |
| 1124629423 | Travis Adam Fries | Peer Specialist | 1420 Green Acres Rd, Eugene, OR 97408-1791 | 2020-11-03 |
| Find all providers in EUGENE | ||||
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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.