Braeden Steven Allen Page

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

107842 Issued in OR

Practice address

58646 McNulty Way
Saint Helens, OR 97051-6210

Phone

(503) 396-0823

NPI assigned

Dec 8, 2022

Last updated

Dec 8, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1670457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1083325229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30636 BROWNLEE RD",
            "city": "RAINIER",
            "state": "OR",
            "postal_code": "970483701",
            "telephone_number": "503-396-0823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58646 MCNULTY WAY",
            "city": "SAINT HELENS",
            "state": "OR",
            "postal_code": "970516210",
            "telephone_number": "503-396-0823"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11097 SE 21st Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukie",
            "state": "OR",
            "postal_code": "972227640",
            "country_code": "US",
            "telephone_number": "503-396-0823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAGE",
        "first_name": "BRAEDEN",
        "middle_name": "STEVEN ALLEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-08",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "107842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Owens, QMHA-R
• Joan Lorraine Owens, RN
• Mayra Alejandra Ozaeta, MSW
• Pacific Northwest Renal Services, L.L.C. (PNRS St. Helens Dialysis)
• Emily Anna Paddon, FNP
• Miriam Parker, LCSW
• Megan J Parks
• Pamela Betty Pastore, N.P.
• Paul L Tesar MD PC
• Jennifer Paulson, RDH

• Peer Specialist in Saint Helens, OR
• Providers in Saint Helens, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.