Sisu Healing Partners

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

SISU HEALING PARTNERS

Practice address

1722 NW Raleigh St SPC 410
Portland, OR 97209-1754

Phone

(503) 847-9836

NPI assigned

Dec 16, 2021

Organization subpart

No

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

Authorized official

Name

Tara Rayburn, LICSWA, QMHP,CADCIIINPI 1134584527

Title

Founder & Director

Phone

(971) 645-0148

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• not applicable Other name

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tara Holly Rayburn, CADCI

  • Addiction (Substance Use Disorder) Psychologist
  • Portland, OR
  • NPI 1134584527
  NPD Authorized official

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

{
    "created_epoch": "1639612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639612800000",
    "number": "1093474132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 NW RALEIGH ST UNIT 410",
            "address_2": "MAILBOX 304",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97209",
            "telephone_number": "503-847-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 NW RALEIGH ST SPC 410",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091754",
            "telephone_number": "503-847-9836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISU HEALING PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-16",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A",
        "authorized_official_last_name": "RAYBURN",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "FOUNDER & DIRECTOR",
        "authorized_official_telephone_number": "971-645-0148",
        "authorized_official_credential": "LICSWA, QMHP,CADCIII"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1134584527",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "taralynn@sisuhealingpartners.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "1722 NW Raleigh St Spc 410",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972091754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "not applicable",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ria Jenae Sisk, CRM
• Michael Sisler, LMT
• Jonathan Sisley
• Noelle Sisneros
• Abbie Sisouphanh, MS, CRC
• Tianna Lynn Sitner
• Miranda Sitney
• Emily Camille Sitter
• Dorothea Sittler, LAC
• Geoffrey David Sittler, OTR

• Addiction (Substance Use Disorder) Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.