Corey Dean Anderson

Primary specialty

Adult CompanionTaxonomy code 372600000X

Practice address

5120 SE 118TH Ave
Portland, OR 97266-3250

Phone

(503) 762-3431

NPI assigned

Dec 8, 2011

Last updated

Mar 27, 2014By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Cascadia Health

  dba Cascadia Behavioral Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Portland, OR
  • NPI 1861531162
  NPD (past)

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395878400000",
    "number": "1144598822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8459",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972078459",
            "telephone_number": "503-238-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 SE 118TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972663250",
            "telephone_number": "503-762-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "COREY",
        "middle_name": "DEAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-08",
        "last_updated": "2014-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171M00000X",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Anderson, LPC
• Christopher Laurence Anderson, BS
• Clifford Joe Anderson, MD
• Connie J Anderson, FNP
• Corey Darryl Anderson, PSY.D.
• Courtney Anderson
• Craig Anderson, PT
• Cynthia J Anderson, L.AC.
• D Carol Anderson, PSY.D.
• Daniel Stephen Anderson, DPT

• Adult Companion in Portland, OR
• Providers in Portland, OR by specialty
• Adult Companion in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; 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.