Larissa Birndorf, MSW, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

201504586NP-PP Issued in OR

Practice address

2701 NW Vaughn St Ste 470
Portland, OR 97210-5326

Phone

(503) 719-4648

NPI assigned

Mar 12, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• Active Recovery TMS PLLC

  • Psychiatry Physician
  • Clackamas, OR
  • NPI 1881287787

  WA

  Medicare reassignment NPD
• Northwest IV, LLC

  • Family Nurse Practitioner
  • Portland, OR
  • NPI 1023596541
  Medicare reassignment NPD
• Northwest IV, LLC

  • Family Nurse Practitioner
  • Beaverton, OR
  • NPI 1811600471
  NPD
• Deep Insight PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bend, OR
  • NPI 1316723711
  NPD (past)

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

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1073939211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2873 NW RALEIGH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102464",
            "telephone_number": "503-679-7824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 NW VAUGHN ST STE 470",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105326",
            "telephone_number": "503-719-4648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2828 SW Kelly Ave Ste 6-196",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972014809",
            "country_code": "US",
            "telephone_number": "503-477-7878",
            "fax_number": "888-765-0392",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19075 NW Tanasbourne Dr",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971245860",
            "country_code": "US",
            "telephone_number": "844-966-6777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2029 SE Jefferson St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Milwaukie",
            "state": "OR",
            "postal_code": "972227605",
            "country_code": "US",
            "telephone_number": "503-664-4127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BIRNDORF",
        "first_name": "LARISSA",
        "credential": "MSW, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-12",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201393260RN",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201504586NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sam Birkemeier
• Susan G Birkemeier, MD
• Asha Birmingham, PHARMD
• Laila Birn, LMT
• Gregory Evan Birnbaum
• Marjorie McCormack Birnie, P.T.
• Colette Valerie Biro, PHARMD
• Matthew Biron, MD
• Carly Biros, LCSW
• Sara Birrer, DMD

• Psychiatric/Mental Health Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.