DR. GRANT TYRONE GODBEY (NPI# 1902936594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902936594 |
| Entity Type | Individual |
| Full Name | DR. GRANT TYRONE GODBEY |
| Credential | MD |
| Practice Address |
722 Ne 162nd Ave Portland OR 97230-5760 |
| Mailing Address |
30125 Sw Old Well Rd West Linn OR 97068-9535 |
| Practice Telephone | 5032554205 |
| Practice Fax Number | 5032555095 |
| Mailing Telephone | 5036563579 |
| Mailing Fax Number | 5036552134 |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
MD15659 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
722 NE 162ND AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97230-5760 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235237983 | Catherine N. Knox | Counselor | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2006-09-20 |
| 1548860463 | Michele Renee Coon | Counselor | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2020-10-29 |
| 1710594551 | Anna Christine Peaslee | Social Worker | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2020-09-25 |
| 1164040739 | Samantha Bedker | Social Worker | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2020-07-10 |
| 1417572033 | Veronica Shiu Knight | Social Worker | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2020-06-09 |
| 1215550850 | Nathalie Wuebkes | Technician | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2020-05-18 |
| 1104446509 | Erin Marie Mcdermott | Behavior Technician | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2020-04-26 |
| 1174150536 | Jessica Schnur | Marriage & Family Therapist | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2020-03-25 |
| 1710529714 | Dickovita Kankanamge Nirmani Tilakasena | Counselor | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2019-10-10 |
| 1568003978 | Sarah Lehman | Technician | 722 Ne 162nd Ave, Portland, OR 97230-5760 | 2019-10-07 |
| 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 | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831455211 | Nicholas Austin | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Rd Dept Of, Portland, OR 97239-3011 | 2012-04-10 |
| 1235446303 | Ervin Gene Stubbs | Psychiatry & Neurology | 7032 Sw 3rd Ave, Portland, OR 97219-2214 | 2010-09-09 |
| 1851525620 | Sarah Morgan Schrauben | Psychiatry & Neurology | 870 Se 82nd Ave., Portland, OR 97027 | 2009-05-08 |
| 1700077328 | Hanh Ngoc Nguyen | Psychiatry & Neurology | 5410 Sw Macadam Ave Ste 200, Portland, OR 97239 | 2007-08-08 |
| 1912116013 | John Barrows Chenoweth | Psychiatry & Neurology | 5410 S.w. Macadam Ave, Ste 200, Portland, OR 97239-3825 | 2007-05-22 |
| 1043340219 | Birgit Meyer | Psychiatry & Neurology | 3415 Se Powell Blvd., Portland, OR 97202 | 2007-03-06 |
| 1518029768 | Barbara Jean Baker | Psychiatry & Neurology | 1818 Se Division St, Portland, OR 97202-1159 | 2006-12-14 |
| 1790851574 | Dena K Drasin | Psychiatry & Neurology | 6834 Se 28th Ave, Portland, OR 97202-8705 | 2006-11-25 |
| 1700966926 | Jonathan Joseph Valen | Psychiatry & Neurology | 506 Sw 6th Ave, Ste 602, Portland, OR 97204-1533 | 2006-10-16 |
| 1275628380 | Kenneth David Holladay | Psychiatry & Neurology | 9830 Ne Cascades Pkwy, Suite 200, Portland, OR 97220-6832 | 2006-10-04 |
| 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.