Individual provider Active NPI

Christina Marie Adams, AUD, CCC-A

  • Audiologist
  • Portland, OR
National Provider Identifier
1023328929
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
30960 Issued in OR
Practice address
3502 NE Broadway St
Portland, OR 97232-1821
Phone
(503) 284-1906
Fax
(503) 546-0894
NPI assigned
Oct 14, 2010
Last updated
Jun 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 30960 OR Primary

Addresses

Primary practice location

3502 NE Broadway St
Portland, OR 97232-1821

Mailing address

3502 NE Broadway St
Portland, OR 97232-1821
Phone (503) 284-1906

Other practice location 1

5200 S MacAdam Ave Ste 200
Portland, OR 97239-3800
Phone (503) 719-4208

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30960ORMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Audiology Clinic, LLC Audiologist CurrentSince Jun 30, 2024 Accepting new patients
Valley ENT, PC PastSince Oct 14, 2010 Accepting new patients

Locations

3502 NE Broadway St
Portland, OR 97232
Phone (503) 284-1602

5200 S Macadam Ave
Ste 200
Portland, OR 97239
Phone (503) 470-3153

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1023328929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 NE BROADWAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321821",
            "telephone_number": "503-284-1906",
            "fax_number": "503-546-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 NE BROADWAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321821",
            "telephone_number": "503-284-1906",
            "fax_number": "503-546-0894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5200 S MacAdam Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393800",
            "country_code": "US",
            "telephone_number": "503-719-4208",
            "fax_number": "503-719-4209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "AUD, CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-14",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OR",
            "license": "30960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.