Individual provider Active NPI

Sharon M Hatrak

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1144704214
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C1107 Issued in OR
Practice address
12636 SE Stark St BLDG J
Portland, OR 97233-1058
Phone
(503) 253-4600
Fax
(503) 253-4609
NPI assigned
Sep 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C1107 OR Primary

Addresses

Primary practice location

12636 SE Stark St BLDG J
Portland, OR 97233-1058

Mailing address

604 SE 70TH Ave
Portland, OR 97215-2126
Phone (503) 314-6982

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260205003686 OR Practitioner - Mental Health Counselor 5890274294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12636 SE Stark St Plaza 125 BLDG J
Portland, OR 97233-1058
Phone (503) 253-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C1107ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Western Psychological and Counseling Services LLC Mental Health CurrentSince Dec 23, 2025 Accepting new patients
Western Psychological and Counseling Services LLC Mental Health CurrentSince Dec 23, 2025 Accepting new patients

Locations

1500 NW Bethany Blvd
Ste 320
Beaverton, OR 97006
Phone (503) 567-3260

880 82nd Dr
Gladstone, OR 97027
Phone (503) 626-9494

12636 SE Stark St
Bldg J
Portland, OR 97233
Phone (503) 253-4600

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.sharonhatrak@148835.advancedmd-direct.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1144704214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 SE 70TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972152126",
            "telephone_number": "503-314-6982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12636 SE STARK ST BLDG J",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331058",
            "telephone_number": "503-253-4600",
            "fax_number": "503-253-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATRAK",
        "first_name": "SHARON",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-24",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C1107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.