COLUMBACARE SERVICES (NPI# 1841718574) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841718574 |
| Entity Type | Organization |
| Organization Name | COLUMBACARE SERVICES |
| Other Organization Name | DBT PROGRAM |
| Practice Address |
17720 Ne Halsey St Ste B Portland OR 97230-6771 |
| Mailing Address |
3587 Heathrow Way Medford OR 97504-4004 |
| Practice Telephone | 5036547654 |
| Practice Fax Number | 5036547333 |
| Mailing Telephone | 5418588170 |
| Mailing Fax Number | 5418588167 |
| Enumeration Date | 2017-09-01 |
| Last Update Date | 2017-09-01 |
| Authorized Official Name | MIKE DAVID SEWITSY (FINANCE DIRECTOR) |
| Authorized Official Telephone | 5418588170 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| DBT Program | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679073712 | Columbacare Services | Community Based Residential Treatment Facility, Mental Illness | 622 57th St, Springfield, OR 97478-6821 | 2018-02-15 |
| 1518201151 | Columbacare Services | Community Based Residential Treatment Facility, Mental Illness | 210 Cove Lane, Brookings, OR 97415 | 2012-11-20 |
| 1619582996 | Columbacare Services | Clinic/Center | 1057 Patterson St, Eugene, OR 97401-3315 | 2020-09-13 |
| 1346855624 | Columbacare Services | Community Based Residential Treatment Facility, Mental Illness | 17710 Ne Halsey St, Portland, OR 97230-6734 | 2020-09-13 |
| 1629603196 | Columbacare Services | Community Based Residential Treatment Facility, Mental Illness | 70362 Kunze Ln, Boardman, OR 97818-8013 | 2020-03-05 |
| 1508420076 | Columbacare Services | Community Based Residential Treatment Facility, Mental Illness | 29398 Recovery Way, Junction City, OR 97448-8442 | 2019-04-30 |
| 1942762547 | Columbacare Services | Psychiatric Residential Treatment Facility | 29398 Recovery Way Ste 3, Junction City, OR 97448-8442 | 2019-04-02 |
| 1902374531 | Columbacare Services | Clinic/Center | 3200 Juanipero Way, Medford, OR 97504 | 2018-11-13 |
| 1992223630 | Columbacare Services | Clinic/Center | 503 Airport Rd Ste 101, Medford, OR 97504-4159 | 2017-09-01 |
| Street Address |
17720 NE HALSEY ST STE B |
| City | PORTLAND |
| State | OR |
| Zip Code | 97230-6771 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710167242 | Michael Jensen | Counselor | 17720 Ne Halsey St Ste B, Portland, OR 97230-6771 | 2007-11-13 |
| 1821659509 | Cassandra C Yerger | Counselor | 17720 Ne Halsey St Ste B, Portland, OR 97230-6771 | 2019-06-24 |
| 1265096523 | Charlotte L Weaver | Counselor | 17720 Ne Halsey St Ste B, Portland, OR 97230-6771 | 2019-04-23 |
| 1255807558 | Caroline B Kavanagh | Counselor | 17720 Ne Halsey St Ste B, Portland, OR 97230-6771 | 2018-10-15 |
| 1871075127 | Amanda D Potter | Counselor | 17720 Ne Halsey St Ste B, Portland, OR 97230-6771 | 2018-09-04 |
| 1639657133 | Selena A Brever | Counselor | 17720 Ne Halsey St Ste B, Portland, OR 97230-6771 | 2018-08-06 |
| 1407342959 | Claire V Carmony | Counselor | 17720 Ne Halsey St Ste B, Portland, OR 97230-6771 | 2018-07-09 |
| 1255832119 | Jamie D Jones | Counselor | 17720 Ne Halsey St Ste B, Portland, OR 97230-6771 | 2018-02-26 |
| 1144721606 | Amber Rachele Harrison | Counselor | 17720 Ne Halsey St Ste B, Portland, OR 97230-6771 | 2018-02-21 |
| 1982103834 | Jack S Bodily | Counselor | 17720 Ne Halsey St Ste B, Portland, OR 97230-6771 | 2018-02-06 |
| Find all providers in the same location | ||||
| 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 | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851999841 | Laura Gottfried Lcsw Inc. | Clinic/Center | 145 Newbury St Ste 2, Portland, ME 04101-4261 | 2020-10-13 |
| 1265039564 | Embodied Life Therapy Center LLC | Clinic/Center | 6906 N Richards St, Portland, OR 97203-6138 | 2020-10-08 |
| 1720685696 | Pragmatic Healing LLC | Clinic/Center | 3930 Sw Plum St Apt 1, Portland, OR 97219-6046 | 2020-10-05 |
| 1467086215 | Deborah Ann Jewell | Clinic/Center | 5627 Ne Simpson St, Portland, OR 97218-2329 | 2020-03-01 |
| 1174023808 | Blake Locher Counseling, LLC | Clinic/Center | 1020 Sw Taylor St Ste 449, Portland, OR 97205-2556 | 2018-02-19 |
| 1134633100 | Paul Myers, Ph.d., LLC | Clinic/Center | 5441 Sw Macadam Ave Ste 104, Portland, OR 97239-3821 | 2017-11-28 |
| 1891206785 | Janz Consulting | Clinic/Center | 1020 Sw Taylor St Ste 635, Portland, OR 97205-2524 | 2017-10-18 |
| 1467979914 | Awakened Heart Pdx, LLC | Clinic/Center | 322 Nw 5th Ave Ste 308, Portland, OR 97209-3851 | 2017-08-25 |
| 1669739389 | Casco Bay Medical Pllc | Clinic/Center | 371 Fore St, 201, Portland, ME 04101-5112 | 2012-04-19 |
| 1306132220 | Patricia Camplair, Phd PC | Clinic/Center | 1020 Sw Taylor St Ste 720, Portland, OR 97205-2512 | 2011-06-20 |
| 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.