Active NPI
Jeffery Warila, CPO
- Prosthetist
- Portland, OR
National Provider Identifier
1023497526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetist
- Practice address
- 17316 NE Halsey St
Portland, OR 97230-6026 - Phone
- (503) 257-6623
- Fax
- (503) 257-6624
- NPI assigned
- May 29, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | |||
| Prosthetist | 224P00000X | Primary |
Addresses
Primary practice location
17316 NE Halsey St
Portland, OR 97230-6026
Mailing address
17316 NE Halsey St
Portland, OR 97230-6026
Phone (503) 257-6623
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 297519 | Medicaid | OR |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432857600000",
"number": "1023497526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17316 NE HALSEY ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972306026",
"telephone_number": "503-257-6623",
"fax_number": "503-257-6624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17316 NE HALSEY ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972306026",
"telephone_number": "503-257-6623",
"fax_number": "503-257-6624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARILA",
"first_name": "JEFFERY",
"credential": "CPO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-05-29",
"last_updated": "2015-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": null,
"license": null,
"primary": false
},
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "297519",
"state": "OR"
}
],
"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 May 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.